Identifying Barriers to Sequential Compression Device Compliance at a Rural Level 1 Trauma Center

Abstract

Venous thromboembolism (VTE) risk is significantly higher for hospitalized trauma patients. Sequential compression devices (SCDs) serve as standard mechanical prophylaxis for VTE; however, compliance remains suboptimal. We examined frequency of SCD usage and barriers to utilization. This prospective cohort study enrolled 119 trauma patients at a Level 1 Trauma Center between June 2024 and July 2024. Patients were observed for three days or until discharge. Patient education on SCDs was provided by investigators on observation day 1, and utilization was tracked. Among 119 patients, ICU usage (77.5%-100%) was significantly higher than PCU/Med Surg (42.0%-45.3%) (p<0.001). Non-adherence initially stemmed from malfunctioning or absent equipment (p<0.001) but later shifted to the underutilization of functioning SCDs (p<0.001). Patients without chemical prophylaxis had higher odds of using SCDs (p=0.029). Non-ICU settings in particular faced equipment and monitoring challenges, which impaired utilization. Improving equipment availability, staff training, and patient education could enhance SCD prophylaxis.