Educating Nurses About Venous Thromboembolism (VTE) Prevention

NCT02301793 | Completed Results

• 1 other identifier: NA_00043860
• Study Type: interventional
• Target: 933
• Locations: 1 country
• Sites: 1

Brief Summary

As part of mandatory on-going nursing education, the investigators have incorporated identical information into two distinct web-based learning formats - the traditional linear PowerPoint format (with voice-over) and a new interactive format developed with central nursing education. The investigators will cluster randomize nurses by floor to receive either the traditional education or the new interactive education, and evaluate the impact on administration of VTE prophylaxis doses administered by nurses before and after education. All nurses on a floor will receive the same educational format. If one method of education results in statistically significant improvement in VTE prophylaxis administration, the investigators will cross over to deliver the superior education format to all nurses who originally were given the less effective method.

Conditions

Venous Thromboembolism; Venous Thrombosis

Outcome Measures

Primary Outcomes (1)

• Non Administration of Prescribed VTE Prophylaxis Medication Doses

  This is the percentage of VTE prophylaxis doses that were not administered for any reason as documented in the electronic health record by a nurse

  (Baseline); approximately 3 months later (Post-Education)

Secondary Outcomes (4)

• Rates of All VTE Among Hospitalized Patients

  3-12 months after end of study

• Rates of Deep Vein Thrombosis (DVT) Among Hospitalized Patients

  3-12 months after end of study

• Rates of Pulmonary Embolism (PE) Among Hospitalized Patients

  3-12 months after end of study

• Proportion of Non Administration of Prescribed VTE Prophylaxis Medication Doses Which Are Documented as Patient Refusal

  Baseline; approximately 3 months later (post education)

Study Arms (2)

Contemporary Education Format

EXPERIMENTAL

Nurses in this arm received education about venous thromboembolism (VTE) in a web-based contemporary interactive format. Intervention: Nurse education in contemporary format

Behavioral: Nurse education in contemporary format

Traditional Education Format

ACTIVE COMPARATOR

Nurses in this arm received education about venous thromboembolism (VTE) in a web-based traditional linear PowerPoint format with voice over. Intervention: Nurse education in traditional format

Behavioral: Nurse education in traditional format

Interventions

Nurse education in contemporary format BEHAVIORAL

Education about VTE was delivered through a web-based contemporary interactive format

Contemporary Education Format

Nurse education in traditional format BEHAVIORAL

Education about VTE was delivered through a web-based traditional linear Powerpoint format with voice over.

Traditional Education Format

Eligibility Criteria

• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• Nurses on selected surgical and medical floors at Johns Hopkins Hospital

You may not qualify if:

• Nurses who were not permanently associated with one of the 21 hospital floors (e.g. traveling nurse, float nurse) were excluded from this study

Sponsors & Collaborators

• Johns Hopkins University: lead
• Patient-Centered Outcomes Research Institute: collaborator

Study Sites (1)

Johns Hopkins Medical Institutions

Baltimore, Maryland, 21287, United States

Location

Related Publications (3)

• Shermock KM, Lau BD, Haut ER, Hobson DB, Ganetsky VS, Kraus PS, Efird LE, Lehmann CU, Pinto BL, Ross PA, Streiff MB. Patterns of non-administration of ordered doses of venous thromboembolism prophylaxis: implications for novel intervention strategies. PLoS One. 2013 Jun 14;8(6):e66311. doi: 10.1371/journal.pone.0066311. Print 2013.

  PMID: 23799091 BACKGROUND

• Elder S, Hobson DB, Rand CS, Streiff MB, Haut ER, Efird LE, Kraus PS, Lehmann CU, Shermock KM. Hidden Barriers to Delivery of Pharmacological Venous Thromboembolism Prophylaxis: The Role of Nursing Beliefs and Practices. J Patient Saf. 2016 Jun;12(2):63-8. doi: 10.1097/PTS.0000000000000086.

  PMID: 24681420 BACKGROUND

• Lau BD, Shaffer DL, Hobson DB, Yenokyan G, Wang J, Sugar EA, Canner JK, Bongiovanni D, Kraus PS, Popoola VO, Shihab HM, Farrow NE, Aboagye JK, Pronovost PJ, Streiff MB, Haut ER. Effectiveness of two distinct web-based education tools for bedside nurses on medication administration practice for venous thromboembolism prevention: A randomized clinical trial. PLoS One. 2017 Aug 16;12(8):e0181664. doi: 10.1371/journal.pone.0181664. eCollection 2017.

  PMID: 28813425 DERIVED

Related Links

• PCORI Website Page - "Improving Patient-Nurse Communication to Prevent a Life-Threatening Complication"
• PCORI Website Page - "Preventing Venous Thromboembolism: Empowering Patients and Enabling Patient-Centered Care via Health Information Technology"
• Website to take the nurse education module. "Venous Thromboembolism Prevention: The Nurse's Perspective"

MeSH Terms

Conditions

Venous Thromboembolism; Venous Thrombosis

Condition Hierarchy (Ancestors)

Thromboembolism; Embolism and Thrombosis; Vascular Diseases; Cardiovascular Diseases; Thrombosis

Limitations and Caveats

This trial was conducted in a single center potentially limiting the generalizability of our findings. The differences associated with education by specific clinical department in the current study was not explored.

Results Point of Contact

• Title: Elliott R Haut M.D, PhD, Associate Professor of Surgery, Anesthesiology &Critical Care Medicine
• Organization: Johns Hopkins Medical Institutions

ehaut1@jhmi.edu

410-502-3122

Study Officials

• Elliott R Haut, MD PhD

  Johns Hopkins University

  PRINCIPAL INVESTIGATOR

Publication Agreements

• PI is Sponsor Employee: Yes

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Masking Details: Within strata, a coin toss (ERH) was used to randomize floors into either the Dynamic education arm or the Static education arm. Based on the outcome of the coin toss, nurses were then remotely assigned the online education module by an institutional nurse educator (DLS). The assigned educational module then appeared in the nurse's list of education assignments for completion within the institutional Learning Management System. Nurses are required to complete clinically relevant education regularly as part of ongoing professional practice and a waiver of consent was provided by the IRB; therefore nurses were not aware of their participation in a trial nor were they aware that two education modules existed. Additionally, the VTE prophylaxis medication non-administration dataset provided to the biostatistical team (i.e. outcomes assessors) for analysis was blinded by treatment arm and department.
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: One arm was provided linear static education (Static) using PowerPoint slides with voiceover to cover the concepts. The other arm was provided interactive learner-centric dynamic scenario-based education (Dynamic), where each scenario resulted in either positive reinforcement or corrective feedback with an opportunity to apply knowledge to a new scenario.

Study Record Dates

• First Submitted: November 22, 2014
• First Posted: November 26, 2014
• Study Start: April 1, 2014
• Primary Completion: March 31, 2015
• Study Completion: March 31, 2015
• Last Updated: May 17, 2019
• Results First Posted: May 17, 2019

Record last verified: 2019-05

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)