An evaluation of critical care nurses' perceived knowledge and practices of venous thromboembolism

Abstract

Background: Venous thromboembolism (VTE), including deep vein thrombosis and pulmonary embolism, is a significant contributor to hospital in-patients’ morbidity and mortality, particularly in critical care settings. Patients in these environments face increased risks due to immobility, surgical procedures, and multiple comorbidities. Nurses are integral to the prevention, assessment, and management of VTE, yet gaps in their knowledge and actual practices may compromise patient outcomes. This study evaluates the knowledge and practices of critical care nurses in Malta concerning VTE care. Methodology: A cross-sectional, quantitative research design was employed. Data was collected from critical care nurses (n=98) via a structured, validated questionnaire adapted from an existing validated tool, aligned with updated VTE guidelines. Descriptive and inferential statistics were used to assess demographic variables, self-rated and actual knowledge, VTE-related practices, self-efficacy, and perceived barriers to VTE risk assessment. Findings: The study revealed moderate knowledge and practice scores among participants. Nurses demonstrated stronger knowledge of common VTE risk factors but struggled to identify less familiar or complex ones. Confidence was highest in patient education and lowest in technical interventions such as mechanical prophylaxis application. Training attendance was low, though positively rated by those who had received it. No significant correlations were observed between demographic variables and knowledge or practice scores. Barriers such as workload, limited training, and unclear protocols were more strongly associated with practice variability. Conclusion: The research highlights that while knowledge of VTE was moderate among participants, it did not necessarily translate into consistent VTE care practices. Effective practice requires institutional support, structured and context-specific training, and the integration of clear, accessible protocols. Addressing systemic and environmental barriers is essential to improving patient safety and nursing performance in critical care settings.