Upon conducting my research, I came across a systemic review titled "Effectiveness of ambulation to prevent venous thromboembolism in patients admitted to the hospital". The research concluded that a significant decrease in VTE were shown when implementing a hospital-wide ambulatory protocol. This was conducted by offering autonomous ambulation for hospitalized patients with documentation of how long, how frequent, and the length the patient ambulated in an effort to decrease instance of a VTE (Lau et al., 2020).

A second research article titled "Role of ambulation to prevent venous thromboembolism in medical patients: where do we stand?", went on to find that defining immobility is of great importance when assessing mobility status and risk for for the development of blood clots (VTE). By creating a standardized definition of "immobility" across the board, hospitals can implement the necessary screening tools and ambulatory protocols, while also decreasing mortality rates in high risk patients (Chindamo et al., 2019).

A third research article titled "Early ambulation and prevention of post-operative thrombo-embolic risk", went on to discuss prevention measures in postoperative patients at risk for VTE. Research showed an 84% reduction in deep vein thrombosis (DVT) after institution of a mechanical prophylaxis in conjunction with prescribed pharmacological thromboprophylaxis (Talec et al., 2016).

VTE prophylactic protocols in healthcare facilities

• Development and utilization of hospital-wide VTE protocols can avoid increased hospital stays and lower healthcare costs. VTE protocols should include how early, how vigorous, and how often autonomous or assisted ambulation should occur to prevent VTE (ex. DVT or PE) (Lau et al., 2020).

Adherence to pharmacological prophylaxis

• If a patient refuses pharmacological intervention(s), the nurse should institute patient teaching on why it is important to take antiplatelet or anticoagulant medications whilst hospitalized. Inclusion of easy to interpret pamphlets, videos, one-pagers, etc. should be provided to all patients at risk for developing a blood clot. To prevent re-hospitalization, every patient should receive appropriate discharge teaching to prevent another incidence of VTE postoperatively. This can be done by thoroughly explaining the signs and symptoms of a VTE, providing instructions on what to do and who to call if experiencing symptoms, pamphlets on lifestyle changes, etc.

• Goal Setting This can be done by establishing rapport and ensuring comfortability, the interdisciplinary team can intervene and provide significant improvements in patient outcomes, compliance, and overall patient satisfaction postoperatively. Motivating patients to participate in their care by encouraging questions about how often they should exercise, how to prevent VTE, signs and symptoms of a DVT, lifestyle changes, medication compliance, the use of compression stockings, etc.

BSN Program Student Learning Outcome (PSLO) #2: provide safe, competent, and effective nursing care to patients throughout the lifespan.

BSN Program Student Learning Outcome (PSLO) #6: apply research findings to promote evidence-based practice (EBP).

Development of venous thromboembolism(s) postoperatively, as a result of prolonged immobilization, is a preventable complication found in hospitalized patients. In an effort to decrease incidences of VTE, nurses are responsible for providing patients with safe and effective nursing care in conjunction with evidence-based care to prevent these occurrences. Nurses can continue to do their due diligence by following hospital wide VTE protocols, initiating goal setting with the patient and their family, institution of patient teaching, etc. The conduction of research surrounding the topic of DVT prevention in postoperative patients, has led to the adoption of evidence-based practices/care in the healthcare setting today. These concepts learned at Sentara College of Health Sciences (SCOHS) has prepared me to take on a leadership role by highlighting the importance of utilizing EBP in the deliverance of patient care.