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CS445
Venous Thromboembolism (VTE): A new look at an old problem
By: Dorothy Bybee; Blessing Hospital; Quincy, IL
For further information, please contact: dbybee@blessinghospital.com
Purpose: Approximately 900,000 Americans are newly diagnosed with some form of VTE each year. VTE has been identified as a preventable complication and one that nursing can play a vital role. A team was formed to determine an evidence-based process for VTE prophylaxis.
Description: The goal of the team was to develop a standard order set and risk screening criteria involving both physician and nursing. The literature was searched and an evidence table created to determine the existing evidence and recommendations for VTE prophylaxis. Nursing was given the autonomy to determine the type of mechanical prophylaxis based on screening criteria. The screening was created within the electronic record for efficiency and consistency. The order set provides pharmacological prophylactic choices for the physicians and a physician risk assessment reference. An electronic alert was created for the physicians to remind them to review the order set and choose pharmacological prophylaxis as indicated. Patient education was created to support the process and involve the patient in prophylaxis. The emphasis was that VTE prevention is collaboration between physician, nurse and patient.
Evaluation and Outcomes: An evidence-base process was developed based on the information available. Patients are now screened upon admission for VTE risk against standard criteria. The documentation is consistently completed in the electronic record and the appropriate mechanical prophylaxis applied. A pilot demonstrated increased compliance with VTE prophylaxis and an increase in the use of pharmacological prophylaxis.
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