Overview
Venous thromboembolism (VTE) is the collective term used to describe deep vein thrombosis (DVT) and pulmonary embolism (PE). What is DVT? DVT is a clot formation within the deep vasculature in the legs. What is PE? PE is a clot within the lungs which usually derives from the DVT. There are multiple risk factors for VTE including venous stasis, hypercoagulable states, immobilization, surgery and trauma, pregnancy, oral contraceptives and estrogen replacement, and malignancy. It is believed that approximately 1 million cases of VTE occur in the U.S. each year, resulting in 300,000 deaths annually, but the exact incidence of VTE is unknown.
DVT and PE, are among the most common preventable causes of in-hospital mortality, according to Aziz & Comerota, (2013). This acute event can occur with prolonged immobility, after surgical procedures and trauma, and in the presence of inherited coagulation abnormalities or even cancer. Although VTE is among the most common preventable causes of death among hospitalized patients in the United States, it unfortunately is often overlooked as a major public health problem and viewed more as a complication of hospitalization for another illness, rather than as a specific disease entity (Bruni-Fitzgerald, 2015). Purpose The purpose of identifying patients at high risk for developing DVT is crucial to ensure that these patients are receiving appropriate mechanical and pharmacological prophylaxis against DVT formation. …show more content…
Implementing the appropriate prevention measure can prevent the occurrence of DVT formations and reduce mortality of hospitalized patients. Utilizing an evidence-based VTE prevention guideline and improving VTE prophylaxis rates for all medical and surgical inpatients is imperative in providing the best care for those who are unable to care for themselves.
Nurses play a crucial role in preventing VTE, not only by implementing evidence-based care but also by communicating current research and recommendations regarding best care practices. VTE often is preventable through use of collaborative care pathways with the use of recommended protocols as part of safe nursing practice (Tietze & Gurley, 2014). Nursing staff can help by identifying process changes that can be instituted to prevent the failure of VTE prophylaxis implementation. These process changes can include check offs imbedded in order sets, handoffs, and electronic notifications. Setting The setting for this issue is a regional hospital with 350 plus in-patient beds. This facility services a wide variety of healthcare issues from out-patient services to long term inpatient care. Nursing care ranges from patient care technicians (PCTs), Licenses Practical Nurses (LPNs), and Registered Nurses (RNs), along with many other interdisciplinary teams. The nurse to patient ratio on the medical surgical floors range for 6:1, the stepdown/progressive care floors 4:1, and the intensive care units 2:1, although the ratios can vary depending on the needs of the patients. This hospital is also a teaching facility, hosting the local university, outlying rural centers, and a medical school. Documentation within the facility relies on electronic medical record system as well as some functional paper charts. Problem The problem identified is the substandard use of VTE prophylaxis. …show more content…
In reviewing current policies and protocols, it was found that the use of VTE prophylaxis is considerably less than expected. Nursing staff in general are not fully educated on how to utilize the protocol and have a lack of understanding of the benefits of VTE prophylaxis. The protocol is not clearly defined and many nurses leave the decision up to the physician to order a VTE set, essentially if the MD didn’t order it then the MD didn’t want it. Also, nursing staff fail to adhere to current orders and do not act progressively to reapply mechanical prophylaxis regularly. Intervention Develop an in-service for all nursing staff, which includes schedulers, unit clerks, nurses, and physical therapist, as this will aide in the understanding of the use of VTE prophylaxis. Each area identified has staff that interacts with patients or patient orders on a regular basis. Increasing education and awareness of the VTE prophylaxis benefits will promote engagement and understanding. Holding staff accountable, whether it is a nurse failing to implement or a physical therapy aide who fails to reapply devices, bringing all departments within the fold of adhering to best practice guidelines. Educating the staff on the treatments available for medical patients versus surgical patients, as each have different needs for DVT prophylaxis, should include consideration of
Venous thromboembolism (VTE) is the collective term used to describe deep vein thrombosis (DVT) and pulmonary embolism (PE). What is DVT? DVT is a clot formation within the deep vasculature in the legs. What is PE? PE is a clot within the lungs which usually derives from the DVT. There are multiple risk factors for VTE including venous stasis, hypercoagulable states, immobilization, surgery and trauma, pregnancy, oral contraceptives and estrogen replacement, and malignancy. It is believed that approximately 1 million cases of VTE occur in the U.S. each year, resulting in 300,000 deaths annually, but the exact incidence of VTE is unknown.
DVT and PE, are among the most common preventable causes of in-hospital mortality, according to Aziz & Comerota, (2013). This acute event can occur with prolonged immobility, after surgical procedures and trauma, and in the presence of inherited coagulation abnormalities or even cancer. Although VTE is among the most common preventable causes of death among hospitalized patients in the United States, it unfortunately is often overlooked as a major public health problem and viewed more as a complication of hospitalization for another illness, rather than as a specific disease entity (Bruni-Fitzgerald, 2015). Purpose The purpose of identifying patients at high risk for developing DVT is crucial to ensure that these patients are receiving appropriate mechanical and pharmacological prophylaxis against DVT formation. …show more content…
Implementing the appropriate prevention measure can prevent the occurrence of DVT formations and reduce mortality of hospitalized patients. Utilizing an evidence-based VTE prevention guideline and improving VTE prophylaxis rates for all medical and surgical inpatients is imperative in providing the best care for those who are unable to care for themselves.
Nurses play a crucial role in preventing VTE, not only by implementing evidence-based care but also by communicating current research and recommendations regarding best care practices. VTE often is preventable through use of collaborative care pathways with the use of recommended protocols as part of safe nursing practice (Tietze & Gurley, 2014). Nursing staff can help by identifying process changes that can be instituted to prevent the failure of VTE prophylaxis implementation. These process changes can include check offs imbedded in order sets, handoffs, and electronic notifications. Setting The setting for this issue is a regional hospital with 350 plus in-patient beds. This facility services a wide variety of healthcare issues from out-patient services to long term inpatient care. Nursing care ranges from patient care technicians (PCTs), Licenses Practical Nurses (LPNs), and Registered Nurses (RNs), along with many other interdisciplinary teams. The nurse to patient ratio on the medical surgical floors range for 6:1, the stepdown/progressive care floors 4:1, and the intensive care units 2:1, although the ratios can vary depending on the needs of the patients. This hospital is also a teaching facility, hosting the local university, outlying rural centers, and a medical school. Documentation within the facility relies on electronic medical record system as well as some functional paper charts. Problem The problem identified is the substandard use of VTE prophylaxis. …show more content…
In reviewing current policies and protocols, it was found that the use of VTE prophylaxis is considerably less than expected. Nursing staff in general are not fully educated on how to utilize the protocol and have a lack of understanding of the benefits of VTE prophylaxis. The protocol is not clearly defined and many nurses leave the decision up to the physician to order a VTE set, essentially if the MD didn’t order it then the MD didn’t want it. Also, nursing staff fail to adhere to current orders and do not act progressively to reapply mechanical prophylaxis regularly. Intervention Develop an in-service for all nursing staff, which includes schedulers, unit clerks, nurses, and physical therapist, as this will aide in the understanding of the use of VTE prophylaxis. Each area identified has staff that interacts with patients or patient orders on a regular basis. Increasing education and awareness of the VTE prophylaxis benefits will promote engagement and understanding. Holding staff accountable, whether it is a nurse failing to implement or a physical therapy aide who fails to reapply devices, bringing all departments within the fold of adhering to best practice guidelines. Educating the staff on the treatments available for medical patients versus surgical patients, as each have different needs for DVT prophylaxis, should include consideration of