DVT Prevention and Anticoagulant Management Aims Measures Literature Data.
-
Upload
winfred-stewart -
Category
Documents
-
view
217 -
download
0
Transcript of DVT Prevention and Anticoagulant Management Aims Measures Literature Data.
DVT Prevention and Anticoagulant Management
•Aims•Measures•Literature•Data
DVT Prevention and Anticoagulant Management
• Aims (What are we trying to accomplish?)– Reduce the incidence of DVT and PE in hospitalized
patients by 50% in one year.
– Reduce readmissions within 31 days for DVT and PE by 50% in one year.
– Reduce patient harm associated with the use of anticoagulant therapy by 50% in one year.
DVT Prevention and Anticoagulant Management
• Measures (How will we know that a change is an improvement?)
– Hospital Acquired DVT per 1000 Discharges
– Hospital Acquired PE per 1000 Discharges
– Readmissions within 31 Days with DVT per 1000 Discharges
– Readmissions within 31 Days with PE per 1000 Discharges
– Patient harm associated with anticoagulant therapy as measured by the IHI Adverse Drug Event Trigger Tool
DVT Prevention
• Clinical Goals– Adult patients (18 & older) are assessed for
VTE risk within 24 hours of admission– Appropriate pharmacological and/or
mechanical prophylaxis begins within 24 hrs of admission.
Venous Thromboembolism Prophylaxis, June 2007, ICSI
DVT Prevention
• Clinical Goals– All patients receive education regarding VTE
signs & symptoms, preventive methods– All patients begin early and frequent
ambulation
Venous Thromboembolism Prophylaxis, June 2007, ICSI
DVT Prevention
• Clinical Goals– All adult medical/surgical patients with
moderate-high-very high VTE risks receive anticoagulation prophylaxis unless contraindicated.
– Reduce the risk of complications from pharmacologic prophylaxis.
Venous Thromboembolism Prophylaxis, June 2007, ICSI
DVT Prevention
• Clinical Goals– Appropriate pharmacological and/or
mechanical prophylaxis begins within 24 hrs of admission.
– Mechanical prophylaxis is used when pharmacologic prophylaxis is contraindicated.
– Appropriate precautions for patients receiving spinal or epidural anesthesia are implemented.
Venous Thromboembolism Prophylaxis, June 2007, ICSI
National Patient Safety Goal 3E: Anticoagulation
• Reduce the likelihood of patient harm with the use of anticoagulation (AC) therapy.
• Applies to multiple inpatient and outpatient settings
• Rationale: Anticoagulation therapy is a high risk treatment
NPSG 3E Implementation Expectations:
• Implement a defined AC program
• Use ONLY oral UD products/pre-mixed IV’s
• Warfarin is dispensed for each patient with established monitoring
• Use approved protocols for the initiation & maintenance of AC therapy
NPSG 3E Implementation Expectations:
• Warfarin – baseline/current INR
• Dietary services notification of pt’s receiving warfarin
• Heparin IV by a programmable IV pump
• Policy addresses baseline & ongoing lab tests for Heparin/LMWH
NPSG 3E Implementation Expectations:
• Education for Anticoagulation therapy: prescribers, staff, patients and families.
• Pt./family education covers specific areas
• Evaluation of Anticoagulation safety practices.
Baseline Measures• Hospital Acquired DVT per 1000 Discharges
• Hospital Acquired PE per 1000 Discharges
• Readmissions with DVT per 1000 Discharges
• Readmissions with PE per 1000 Discharges
Time Frame: FY 07