There is a high incidence of venous thrombosis in orthopedic patients. The previous guidelines pointed out that standardized three-step prevention is crucial for patients at high risk of thrombosis. We established a nurse-centered standardized grading of patients with venous thromboembolism based on evidence in previous studies. Promoting the transformation of evidence-based practice is critical to improve clinical quality. Objective Based on the previously constructed prevention plan for venous thromboembolism in orthopedic patients, to carry out the evidence-based practice of standardized graded prevention.

The corresponding indicators and practices of the review of nursing quality were established. According to the results of the baseline review, the obstacle factors and facilitating factors were analyzed, and the action strategies were formulated. A randomized controlled study selected three hundred forty-three patients to verify the effect. The experimental group was given evidence-based practice, while the control group was assigned routine prevention.

According to the evidence-based protocol, five indicators were selected as the review basis (thrombosis risk assessment, bleeding risk assessment, graded prevention, graduated compression stocking wearing, and nursing records) . After evidence-based practice, the incidence of symptomatic VTE in the experimental group was lower than that in the control group (2.45 vs. 2.78 during hospitalization; 1 month after discharge 1.23 vs. 2.22; 3 months after discharge 1.23 vs. 2.22) , the difference was not statistically significant; Before discharge, the scores of thrombosis prevention knowledge in the experimental group were significantly higher than those in the control group (78.79±8.60 vs. 66.05±7.68) , and the difference was statistically significant (P < 0.001) . The scores of nurses' cognitive level of VTE-related knowledge (risk factors and common sites, clinical manifestations, risk assessment, mechanical prophylaxis, drug prophylaxis) were significantly increased, and the difference was statistically significant. The implementation rate of the review items 1, 2, 3, 4 and 6 increased from 36.92%, 20%, 67.69%, 58.46%, 66.15% to 100%, 82.2%, 100%, 100%, 98.16%, with statistical significance (P < 0.001) .

The transformation of evidence-based practice can help reduce symptomatic thrombosis in patients, improve the cognitive level of nurses and patients, promote clinical compliance, and standardize nursing behavior.