Practical Experiences and Challenges for Nurses in the Prevention of Postoperative Venous Thromboembolism in Gynaecological Cancer Patients Based on the Ottawa Model of Research Use: A Qualitative Study
Background: The incident rate of postoperative VTE in gynaecological cancer patients is high. However, taking appropriate prevention and treatment measures can reduce the incidence of VTE in gynaecological patients and improve the prognosis of surgical patients. The Ottawa Model of Research Use (OMRU) provides a comprehensive framework and theoretical guidance for the application of research results and the promotion of practical change. This model is highly suitable as the foundation for VTE prevention decision-making. Previous studies have not explored the prevention of postoperative VTE in gynaecological cancer patients from the perspective of OMRU. Design: A qualitative descriptive design was used. Data were collected from nurses (n = 17) and doctors (n = 2) in the gynaecological oncology departments of two tertiary comprehensive hospitals. The data were analysed using content analysis, and the reporting follows a qualitative research checklist (COREQ). Results: This study conducted interviews with 19 medical staff members in gynecological oncology departments to identify factors influencing the implementation of VTE prevention measures. at the organizational level, The identified facilitating factors include: a heightened awareness of VTE prevention, a strong sense of responsibility among medical staff, personal experiences, departmental supervision, departmental training, management support and communication, quality control and oversight, assessment indicators, training management, incentive measures, and social benefits. At the patient level, facilitating factors include patient preferences, the impact of medical education, and the roles of both patients and their family members. Conversely, at the organizational level, hindering factors include insufficient promotion of preventive measures, a diminished sense of personal value among medical staff, and increased workload. At the patient level, hindering factors include low levels of attention from patients and their families, inadequate patient self-experience, the influence of disease-related factors, negative impacts on patients, and economic burdens. Finally, at the systemic level, there exist intricate challenges pertaining to the optimization of medical record systems and the management of mechanical prevention equipment for VTE. Uncontrollable factors primarily encompass reimbursement policies for VTE prevention initiatives, the expansion of community healthcare services, and the presence of multiple manufacturers of VTE mechanical prevention devices. Conclusions: It is essential to optimize and validate VTE prevention measures implemented by nursing staff is essential. Future efforts should focus on developing a postoperative VTE prevention and care plan for gynecological cancer patients grounded in evidence-based practicesto improve patient outcomes. Aims and objectives: To describe the practical experience of venous thromboembolism (VTE) prevention among gynaecological tumour nursing staff and summarize the influencing factors of VTE prevention measures, including both promotion factors and hindering factors.
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