A theory-based exploration of the uptake of venous thromboembolism prevention clinical practice guidelines to improve patient safety

  • Juliana Abboud

Student thesis: Doctoral ThesisDoctor of Philosophy


Venous thromboembolism is a preventable disease that causes morbidity and mortality in hospitalised patients. Evidence-based clinical practice guidelines include recommendations to prevent venous thromboembolism (VTE) in hospitalised patients. However, available published literature suggests that they are not always followed, and theory is underutilised in investigating guidelines adherence and developing interventions for the prevention of venous thromboembolism in hospitalised patients.
This thesis explored physicians’ uptake of Venous thromboembolism prevention clinical practice guidelines informed by the Theoretical Domain Framework (TDF) and investigated the barriers and facilitators to implementing venous thrombosis embolism prevention clinical practice guidelines in-hospital care to understand how to improve adherence to VTE prevention guidelines in healthcare settings, thus reducing patient morbidity and mortality.

The dissertation work utilised a mixed-method approach for data collection and analysis. It included a systematic review of existing evidence on VTE guidelines effectiveness and interventions. A qualitative study explored factors affecting physicians’ adherence to guidelines informed by the theoretical domain Framework (TDF). A quantitative study (pre-post process evaluation) assessed the extent to which VTE risk assessment is being performed after a quality improvement intervention implementation.

The final chapter integrated the significant common findings of the three studies and discussed them in relation to emerging literature, their practical significance, and recommendations to improve the VTE clinical practice in hospitals.

Thesis embargoed until 31 July 2026.
Date of AwardJul 2022
Original languageEnglish
Awarding Institution
  • Queen's University Belfast
SupervisorMartin Dempster (Supervisor) & Pauline Adair (Supervisor)


  • Venous thromboembolism
  • clinical practice guidelines
  • guidelines implementation
  • theoretical domains framework
  • risk assessment
  • patient safety
  • prophylaxis
  • quality improvement
  • physicians' perceptions

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