Venous Thromboembolism Prophylaxis
Venous thromboembolism (VTE) is a disorder that includes deep vein thrombosis and pulmonary embolism, and is one of the most common preventable complications from hospitalization. Patients who develop deep vein thrombosis can experience pain, swelling, and extreme discomfort. Pulmonary embolism can lead to shortness of breath, chest pain, and death. The majority of hospitalized patients are at risk for developing VTE.
VTE is preventable. Establishing methods to provide appropriate thromboprophylaxis to patients based on standardized risk assessments is a safe, cost-effective and efficacious way to prevent VTE in nearly all patient groups. Providing appropriate thromboprophylaxis for all patients may prevent the pain and discomfort of a thrombus, prevent complications that can extend hospital stays, and even save a life.
Implementation strategies for VTE:
- Establish a regional multidisciplinary committee to guide your VTE prophylaxis implementation strategy throughout your health authority. As a minimum the committee should include an executive sponsor, senior administrative leader, physician champion, pharmacist nurse, and consider inviting patients.
- Develop a regional, written, active policy that requires risk stratification and the ordering of prophylaxis according to guidelines or documentation of deviation from policy.
- Identify clients at risk for VTE using a recommended risk stratification approach at admission and at time of transfer. Embedding a risk stratification tool into pre-printed order sets that can be used at the time of admission or transfer is a proven strategy to achieve maximum compliance with VTE prophylaxis.
- Provide post-discharge prophylaxis for major orthopedic surgery (hip and knee replacements, hip fracture surgery).
- Establish a prospective randomized auditing strategy to monitor compliance with VTE prophylaxis.
- Provide education to health care professionals and clients about the risks of VTE and its prevention.
- Work within your local context to use strategies to increase compliance with your organization’s policy, including the use of computer decision support systems, preprinted orders, auditing and feedback.