Nursing-Led Deep Vein Thrombosis Prevention in Neurosurgery

Inclusion Criteria * Age ≥ 18 years * Any elective or emergency craniotomy, spinal, or other neurosurgical procedure * Expected post-operative hospital stay ≥ 3 days * Patient or legally authorized representative willing and able to give written informed consent Exclusion Criteria * Pre-operative ultrasound or imaging proven DVT or pulmonary embolism * Known hereditary bleeding disorder (e.g., hemophilia) or platelet count \< 50 × 10⁹/L * Chronic therapeutic anticoagulation (warfarin, DOAC, heparin) that cannot be safely stopped, or need for full-dose post-op anticoagulation * Severe liver disease (Child-Pugh class C) or eGFR \< 30 mL/min/1.73 m² * Life-limiting co-morbidity with expected survival \< 30 days * Pregnancy or breastfeeding * Current participation in another interventional VTE trial