Paper
Wednesday, July 21, 2004
This presentation is part of : Challenging the Status Quo: Impact of Evidence-Based Practice
The Use of Knee-Length Versus Thigh-Length Compression Stockings and Sequential Compression Devices
Janet Peterson, RN, BSN1, Bonnie Jean Raingruber, RN, PhD2, Roumelia Decontreaus, RN, BSN3, James Denman, RN, BSN3, Raquel Resuello, ADN1, Winifred Varnau, RN, MSN1, Debra Brady, RN, MSN1, Jane Brown, RN, MSN1, and Jaime Mahnke, N/A1. (1) Center for Nursing Research, UC Davis Medical Center, Sacramento, CA, USA, (2) Division of Nursing and Center for Nursing Research, California State University, Sacramento, and University of California Davis, Sacramento, CA, USA, (3) CNR, UCDMC, Sacramento, CA, USA
Objective: To search the research literature, complete an evidence based policy revision, and evaluate outcomes to decide if knee-length or thigh-length compression stocking (T.E.D.s) and/or sequential compression devices (S.C.D.s.) are more effective and likely to be worn by patients.

Setting, Design, and Method: In reviewing the current T.E.D.s and S.C.D.s policy it was noted that there was no mention of the knee-length version of these devices. Nurses on the acute care evidence based committee conducted a literature review and found evidence that there is no significant difference in the prophylaxis of deep vein thrombosis (DVT) whether knee-length or thigh-length T.E.D.s and/or S.C.D.s are used. The literature also reported that there are many advantages to using knee-length T.E.D.s and/or S.C.D.s over the thigh-high counterparts including ease of use, increased comfort, substantial cost savings, and better compliance. After revising the T.E.D./S.C.D.s policy to include the option to apply knee length devices when appropriate, the committee then designed a survey of 171 patients to determine the level of patient and nurse compliance with both knee length and thigh length devices in six acute care units.

Concept Targeted: Is there research evidence to support the use of thigh vs knee high T.E.D.s and/or S.C.D.s for patients on general medical surgical units?

Findings: With 40 of the 171 surveys completed, preliminary results indicate that patients and nurses are more compliant with knee-length T.E.D.s and S.C.D.s.

Conclusions: Future patient care may be improved as a result of this evidence based policy revision if the final outcome evaluation indicates that knee-length compression stockings and devices are used more often than the thigh-high options because of ease of application, enhanced comfort, and increased compliance.

Implications: Additional studies focused on institution-specific cost savings associated with use of knee-length devices are needed for varied patient populations.

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Sigma Theta Tau International
July 21, 2004