A mixed evidence-based study of current status of subcutaneous injection of prefilled anticoagulant in adult surgical inpa-tients
YANG Ning
ZHANG Mingming
LI Jun
WU Rui
YANG Yang
GUO Jing
WANG Xinran
Abstract：Objective To investigate the current situation and influencing factors of subcutaneous hemorrhage caused by subcutaneous injection of anticoagulants in surgery,and to explore the obstacles to the implementation of evidence based practice.Methods A parallel mixed-methods design was adopted for the study.From January to August 2024,a convenience sampling method was used to investigate the occurrence of subcutaneous bleeding in patients receiving subcutaneous anticoagulant injections in the surgical department of a tertiary grade A hospital in Beijing.In December 2024,nine clinical nurses were selected for interviews to explore the barriers encountered during the imple-mentation of evidence-based practices.Results The incidence of subcutaneous bleeding after pre-filled anticoagulant injection in 755 patients was 35.36%.The risk of subcutaneous hemorrhage in vascular surgery patients was 47.00%that of orthopedic patients(OR=0.470,P=0.003).The possibility of severe subcutaneous hemorrhage in female patients was 1.495 times that of male patients(OR=1.495,P=0.015).The interview results showed that the difficulty in controlling the injection rate and dwell time,the lack of clarity regarding procedures for specific situations and popula-tions,and nurses'existing habits and inconvenience in using tools were the three factors hindering the implementation of evidence.Conclusion For adult surgical inpatients,pre-filled anticoagulant injections carry a risk of subcutaneous hemorrhage.It is necessary to optimize the injection process based on risk stratification,refine operational guidelines for special populations,and enhance procedural standardization with informa-tion technology tools.This will reduce the incidence of subcutaneous hemorrhage and promote continuous quality improvement in nursing care.
Keywords：surgery departmentsubcutaneous injection of anticoagulantsevidence-based practiceinfluencing factorqualitative inter-viewmixed research
Publication Date：2025-09-10
Online Publishing Date：2025-11-21(First online date of this platform, not the publication date of the document)
Pages：5( 808-812 )