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Dit onderzoeksvoorstel richt zich op het evalueren van de effectiviteit van een verpleegkundig zorgprotocol ter preventie van diepe veneuze trombose (DVT) bij patiënten die een openhartoperatie ondergaan. De studie omvat een interventiegroep die het verpleegkundig protocol ontvangt en een controlegroep die routinematige zorg ontvangt. (DVT)

30 oktober 2026 bijgewerkt door: Abdallah Ibraheem Abdallah Halahla, Near East University, Turkey

Ontwikkeling van een Verpleegkundig Zorgprotocol voor de Preventie van Diepe Veneuze Trombose en de Impact op Patiëntuitkomsten na Hartchirurgie

The primary focus of this research proposal is to examine the efficacy of a nursing care protocol in preventing the occurrence of deep vein thrombosis (DVT) in patients undergoing on-pump cardiac surgery. The investigation will encompass an experimental group that will be subjected to a specific intervention, alongside a control group that will adhere to conventional care procedures. The central objective is to exhibit a statistically significant decrease in the incidence of DVT within the experimental group in comparison to the control group. The secondary outcomes involve assessing the severity of DVT instances and the development of associated complications.

The proposed research strategy entails delineating the criteria for selecting participants, outlining methodologies for gathering data, and detailing statistical approaches for analysis. The amassed data will undergo scrutiny through suitable statistical examinations, including chi-square tests, t-tests, or Mann-Whitney U tests, as well as logistic regression analysis. The process of data analysis will involve descriptive statistics, comparative assessments, regression analysis, and subgroup scrutiny. The interpretation of outcomes will be contextualized within the framework of the research objectives and pre-existing scientific knowledge.

The ultimate objective of this study is to enhance the existing understanding of DVT prevention, provide clinically grounded recommendations supported by evidence, and elevate the quality and safety of patient care.

Studie Overzicht

Toestand

Actief, niet wervend

Conditie

Interventie / Behandeling

Gedetailleerde beschrijving

General Information Regarding the Thesis Topic Deep vein thrombosis (DVT) stands as a frequent complication encountered among patients undergoing on-pump cardiac surgery. A variety of interventions and protocols have been explored to forestall DVT, encompassing strategies like pharmacological prophylaxis, intermittent pneumatic leg compression, active toe movement, and supplementary measures. The objective of this survey of recent literature is to present the most current research related to nursing care protocols' impact on DVT prevention within the context of on-pump cardiac surgery patients.

undertook a thorough systematic examination, culminating in the determination that the combined utilization of intermittent pneumatic leg compression and pharmacological prophylaxis constitutes an efficacious approach for averting venous thromboembolism, encompassing DVT. Their conclusions resoundingly advocate for the integration of this dual strategy into a nursing care protocol to forestall DVT in on-pump cardiac surgery patients.

undertook a distinct systematic review with a focus on venous thromboembolic events in adults undergoing extracorporeal membrane oxygenation (ECMO) support. While the review did not exclusively center on on-pump cardiac surgery patients, it does offer valuable insights for managing individuals undergoing cardiac procedures. The review underlines the significance of acknowledging thromboembolic events in patients relying on ECMO support, and it underscores the importance of enacting appropriate prophylactic strategies to stave off DVT.

conducted a systematic review and meta-analysis specifically focusing on hip and knee arthroplasty. Despite the different study population, their findings regarding the use of aspirin as thromboprophylaxis may have implications for on-pump cardiac surgery patients. The review emphasizes the potential of aspirin as a pharmacological intervention for preventing DVT.

In a prospective randomized study, investigated the impact of active toe movement (AToM) on both calf pump function and the occurrence of DVT in patients with acute foot and ankle trauma who were treated with a cast. Although the study did not specifically target individuals undergoing on-pump cardiac surgery, it illuminates the potential advantages of integrating AToM into nursing care strategies to enhance venous return and thwart DVT. The outcomes suggest that incorporating AToM into nursing care protocols for on-pump cardiac surgery patients could hold promising benefits.

In a distinct analysis conducted by Zheng, the authors delved into the advancements in nursing care for elderly patients who experienced postoperative hip fractures and associated DVT in China. Despite the differing study populations, this review offers insightful perspectives on nursing care protocols and optimal approaches to prevent DVT. These insights might hold relevance for on-pump cardiac surgery patients, particularly concerning nursing interventions and tactics to prevent DVT.

specifically examined the risk of DVT in neurosurgery but also discussed prophylaxis protocols and best clinical practices. Although the context varies, the review emphasizes the significance of implementing appropriate prophylaxis protocols to prevent DVT. The insights from this review can be applied to on-pump cardiac surgery patients to guide nursing care protocols.

executed a comprehensive systematic review and meta-analysis to assess the supplementary application of intermittent pneumatic compression in hospitalized patients who were concurrently receiving pharmacologic prophylaxis for venous thromboprophylaxis. The outcomes indicate that the addition of intermittent pneumatic compression has the potential to amplify the effectiveness of pharmacologic prophylaxis. This investigation advocates for the integration of complementary interventions into nursing care protocols for the prevention of DVT in on-pump cardiac surgery patients.

In a randomized controlled trial carried out , the influence of a foot pump on the incidence of DVT subsequent to total knee arthroplasty in patients undergoing treatment with edoxaban was examined. Despite the different patient demographic addressed in the study, the results underscore the prospective advantages of incorporating foot pumps as an adjunctive measure for DVT prevention. Incorporating foot pumps into nursing care protocols for on-pump cardiac surgery patients could potentially yield benefits.

conducted a systematic review and meta-analysis to evaluate the effectiveness and safety of tranexamic acid in high-risk non-cardiac surgical cases necessitating transfusion. Although the study's primary focus does not directly encompass on-pump cardiac surgery patients, the conclusions extend to a broader spectrum of surgical cases. The review indicates that tranexamic acid can effectively curtail bleeding and mitigate the likelihood of transfusions during high-risk surgical procedures. Considering the plausible ramifications of bleeding and subsequent immobility on DVT development, these findings may hold significance for nursing care protocols aimed at averting DVT in on-pump cardiac surgery patients.

executed a randomized placebo-controlled study with the intention of exploring the potential of dexmedetomidine in diminishing occurrences of atrial fibrillation and delirium subsequent to cardiac surgery. While the study focuses on distinct outcomes, it yields insights pertinent to perioperative management and interventions in cardiac surgery cases. The ramifications of atrial fibrillation and delirium on patient mobility and the risk of DVT underscore the potential value of integrating strategies to manage these complications within nursing care protocols, indirectly contributing to DVT prevention.

In their investigation, delved into the impacts of basic exercise, with or without physiotherapy, in staving off DVT in postmenopausal women undergoing coronary artery bypass graft surgery. Despite the divergence in patient demographics from on-pump cardiac surgery cases, the findings underscore the significance of exercise and physiotherapy in DVT prevention. Recognizing the potential advantages of exercise and early mobilization in curtailing DVT risk, integrating these approaches into nursing care protocols for on-pump cardiac surgery patients holds potential value.

A systematic review and meta-analysis undertaken by took a specific focus on the incidence of venous thromboembolism (VTE) and the pros and cons of thromboprophylaxis following cardiac surgery. The review furnishes invaluable perspectives regarding the overarching VTE risk and the effectiveness of thromboprophylaxis strategies. The outcomes underline the importance of well-suited thromboprophylaxis in deterring DVT in cardiac surgery patients, thereby offering informative guidance for nursing care protocols.

executed a study that specifically investigated the influence of a nursing care protocol on the incidence of DVT among critically ill neurological patients. Despite the distinct patient demographic addressed, the outcomes underscore the potential advantages of nursing care protocols in mitigating DVT occurrences. The study imparts insights into the function of nursing interventions and protocols in diminishing DVT risk, which could hold relevance for on-pump cardiac surgery patients.

In an endeavor led by Sachdeva, a systematic review and meta-analysis were conducted regarding the application of graduated compression stockings for the prevention of DVT. The review scrutinizes the efficacy of graduated compression stockings as a preventive measure. While the scope extends beyond on-pump cardiac surgery patients, the findings contribute to the comprehension of compression stockings as an intervention for DVT prevention. Incorporating the utilization of graduated compression stockings into nursing care protocols for on-pump cardiac surgery patients may offer advantages.

performed a study specifically concentrating on DVT and pulmonary embolism in patients undergoing cardiac surgery. The study explores the occurrence and risk factors associated with DVT and pulmonary embolism in this specific patient population. The findings highlight the importance of identifying and addressing risk factors to prevent DVT in cardiac surgical patients, which can be valuable in shaping nursing care protocols.

conducted a systematic review that examined the pros and cons of prophylactic measures for DVT and pulmonary embolus in plastic surgery. Although the study had a different focus on a distinct surgical population, the results provide valuable insights into the potential benefits and risks linked to prophylaxis strategies. Understanding the risks associated with prophylactic measures can contribute to the development of nursing care protocols for preventing DVT in on-pump cardiac surgery patients.

carried out a systematic review on patient preferences and adherence to the proper usage of graduated compression stockings for DVT prevention in surgical patients. While the review does not specifically target cardiac surgery patients, it offers valuable information concerning patient preferences and adherence to compression stockings. Taking patient preferences into consideration and promoting adherence to preventive measures can enhance the effectiveness of nursing care protocols for DVT prevention.

conducted a systematic review and meta-analysis specifically focusing on tranexamic acid in cardiac surgery. Although the study focuses on a different outcome (bleeding control), it provides insights into the use of tranexamic acid, which may indirectly impact DVT prevention. Considering the potential influence of bleeding on DVT occurrence, incorporating strategies for bleeding control into nursing care protocols may indirectly contribute to DVT prevention in on-pump cardiac surgery patients.

Studietype

Ingrijpend

Inschrijving (Werkelijk)

67

Fase

  • Niet toepasbaar

Contacten en locaties

In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.

Studie Locaties

      • Nicosia, Cyprus
        • Facility of Nursing

Deelname Criteria

Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.

Geschiktheidscriteria

Leeftijden die in aanmerking komen voor studie

  • Kind
  • Volwassen
  • Oudere volwassene

Accepteert gezonde vrijwilligers

Nee

Geslachten die in aanmerking komen voor studie

Allemaal

Beschrijving

Inclusion Criteria:Inclusion Criteria

Patients will be eligible for participation in the study if they meet all of the following criteria:

  1. Adult patients aged 18 years or older.
  2. Patients scheduled to undergo elective or urgent on-pump cardiac surgery using cardiopulmonary bypass (e.g., coronary artery bypass grafting, valve replacement or repair, or combined procedures).
  3. Both male and female patients.
  4. Patients admitted to the participating cardiac surgery unit during the study period.
  5. Patients with no evidence of preoperative deep vein thrombosis (DVT) or pulmonary embolism (PE) as confirmed by clinical assessment and/or Doppler ultrasonography when indicated.
  6. Patients who are hemodynamically stable postoperatively and eligible to receive mechanical and/or pharmacological thromboprophylaxis.
  7. Patients able to understand the study procedures and provide written informed consent (or consent obtained from a legal representative when applicable).
  8. Patients expected to survive for at least three months postoperatively, allowing completion of the follow-up period.

Exclusion Criteria:Exclusion Criteria

Patients will be excluded from the study if they meet any of the following criteria:

  1. History of deep vein thrombosis (DVT) or pulmonary embolism (PE) within the previous six months.

  2. Known congenital or acquired coagulation disorders, including but not limited to hemophilia, thrombophilia, or antiphospholipid syndrome.

  3. Patients receiving long-term therapeutic anticoagulation (e.g., warfarin, direct oral anticoagulants) for other medical indications prior to surgery.

  4. Contraindications to pharmacological thromboprophylaxis, such as:

    • Active bleeding
    • Severe thrombocytopenia (platelet count <50,000/µL)
    • History of heparin-induced thrombocytopenia (HIT)
  5. Contraindications to mechanical prophylaxis, including:

    • Severe peripheral arterial disease
    • Skin ulcers, infections, or recent lower-limb surgery preventing device application
  6. Patients undergoing off-pump cardiac surgery or minimally invasive cardiac procedures not requiring cardiopulmonary bypass.

  7. Emergency surgery requiring immediate intervention where preoperative assessment and consent cannot be obtained.

  8. Pregnant or postpartum women.

  9. Patients with severe renal or hepatic failure that may interfere with anticoagulant metabolism or increase bleeding risk.

  10. Patients with documented malignancy under active treatment associated with a markedly elevated thrombotic risk.

  11. Patients unwilling or unable to comply with the study protocol or follow-up schedule.

Studie plan

Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.

Hoe is de studie opgezet?

Ontwerpdetails

  • Primair doel: Preventie
  • Toewijzing: NVT
  • Interventioneel model: Opdracht voor een enkele groep
  • Masker: Geen (open label)

Wapens en interventies

Deelnemersgroep / Arm
Interventie / Behandeling
Experimenteel: Nursing Care Protocol The nursing care protocol designed for this study is a structured, evidence-ba

Nursing Care Protocol The nursing care protocol designed for this study is a structured, evidence-based guideline specifically tailored for on-pump cardiac surgery patients. It differs from existing DVT prevention protocols by integrating four core components: individualized risk stratification (using Padua and Caprini scores), combined pharmacological and mechanical prophylaxis, an early mobilization regimen adapted to post-cardiac surgery tolerance, and a structured patient education component. Unlike generic thromboprophylaxis guidelines, this protocol standardizes nursing-led interventions and monitoring across preoperative, intraoperative, and postoperative stages.

Follow-Up Schedule and Time-Points

Follow-Up Time-Points:

  • Day 0 (Start of prophylaxis / Baseline)
  • Day 3 (Early in-hospital monitoring)
  • Day 7 (or just before discharge)
  • Week 2 (Outpatient follow-up)
  • Month 3 (Long-term follow-up)

Padua Prediction Score is a clinical tool that has been validated and created to identify hospitalized medical patients who are at risk of developing Venous Thromboembolism (VTE).

Caprini's Risk Assessment Model (RAM) is one of the preferred risk scoring systems for assessing VTE chances for surgery patients. Joseph A. Caprini introduced it, which combines the hereditary and environmental risk factors, with a total of more than 40 different variables used in the assessment such as age, body mass index, past occurrence of VTE, varicose veins, presence of cancer, hormone therapy, and the length of immobility. The resulting score then puts patients into risk categories of very low with 0 points, low with 1-2 points, moderate with 3-4 pts., and high with ≥5 points

Andere namen:
  • Anticoagulanttherapie vermindert de kans op bloedstolselvorming bij hoogrisico-individuen door trombusontwikkeling te remmen.
  • Vroege identificatie van risicopatiënten maakt proactieve preventiestrategieën mogelijk, waardoor de kans op complicaties wordt verkleind.
  • Bewegen stimuleert de bloedsomloop en voorkomt veneuze stasis, een primaire risicofactor voor DVT.
  • Goede hydratatie vermindert de bloedviscositeit, wat helpt trombose te voorkomen.
  • Bewustwording stelt patiënten in staat om vroege waarschuwingssignalen te herkennen en tijdig medische hulp te zoeken.
  • Nauwkeurige administratie zorgt voor continuïteit van zorg en vergemakkelijkt de vroege identificatie van mogelijke complicaties.

Wat meet het onderzoek?

Primaire uitkomstmaten

Uitkomstmaat
Tijdsspanne
The primary endpoint is the incidence of symptomatic or confirmed deep-vein thrombosis (DVT) and/or pulmonary embolism (PE) within the 3-month follow-up period. Secondary endpoints include: adherence to the prophylaxis protocol, occurrence of prophylaxis
Tijdsspanne: three months
three months

Medewerkers en onderzoekers

Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.

Sponsor

Medewerkers

Studie record data

Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.

Bestudeer belangrijke data

Studie start (Werkelijk)

14 juni 2024

Primaire voltooiing (Werkelijk)

20 december 2025

Studie voltooiing (Geschat)

1 november 2026

Studieregistratiedata

Eerst ingediend

29 december 2025

Eerst ingediend dat voldeed aan de QC-criteria

8 januari 2026

Eerst geplaatst (Werkelijk)

16 januari 2026

Updates van studierecords

Laatste update geplaatst (Werkelijk)

4 november 2026

Laatste update ingediend die voldeed aan QC-criteria

30 oktober 2026

Laatst geverifieerd

1 oktober 2026

Meer informatie

Termen gerelateerd aan deze studie

Trefwoorden

Andere studie-ID-nummers

  • NEU\2025\138-2044

Informatie over medicijnen en apparaten, studiedocumenten

Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel

Nee

Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct

Nee

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