Document Detail


Evidence-based venous thromboembolism prophylaxis is associated with a six-fold decrease in numbers of symptomatic venous thromboembolisms in rehabilitation inpatients.
MedLine Citation:
PMID:  22192320     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To measure the impact of a standardized risk assessment tool and specialty-specific, risk-adjusted venous thromboembolism (VTE) order sets on compliance with American College of Chest Physicians (ACCP) guidelines and the number of symptomatic VTE as assessed by administrative data.
DESIGN: Prospective cohort study.
SETTING: Academic hospital inpatient rehabilitation unit.
PATIENTS AND PARTICIPANTS: All patients on the rehabilitation unit.
METHODS AND INTERVENTIONS: Assessment of VTE risk factors and evaluated admission VTE prophylaxis orders before and after implementation of an ACCP guideline-based, specialty-specific VTE risk assessment, and prophylaxis order set by using a standardized data collection form.
MAIN OUTCOME MEASURES: Discharge diagnostic codes for VTE and pulmonary embolism were tracked by ICD-9 (International Classification of Diseases, 9th edition) discharge diagnosis codes for the 12 months before and 36 months after the intervention.
RESULTS: Before implementation of the VTE order set, 27% of patients received VTE prophylaxis in compliance with the 2004 ACCP VTE guidelines. By following implementation of specialty-specific, risk-adjusted VTE order sets, compliance increased to 98%. In the year before VTE order-set implementation, the number of VTEs per admission was 49 per 1000. By following implementation, the number of VTEs steadily decreased each year to 8 per 1000 in 2007 (χ(2) = 14.985; P = .0001).
CONCLUSIONS: Implementation of a standardized VTE risk assessment tool and prophylaxis order set resulted in a substantial improvement in compliance with ACCP guidelines for VTE prophylaxis and was associated with a 6-fold reduction in the number of symptomatic VTEs in a hospital-based rehabilitation unit.
Authors:
R Samuel Mayer; Michael B Streiff; Deborah B Hobson; Daniel E Halpert; Sean M Berenholtz
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  PM & R : the journal of injury, function, and rehabilitation     Volume:  3     ISSN:  1934-1563     ISO Abbreviation:  PM R     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-12-23     Completed Date:  2012-05-07     Revised Date:  2012-09-10    
Medline Journal Info:
Nlm Unique ID:  101491319     Medline TA:  PM R     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1111-1115.e1     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD 21208, USA. rmayer2@jhmi.edu
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Female
Guideline Adherence / statistics & numerical data
Hospitalization / statistics & numerical data
Humans
Male
Middle Aged
Prospective Studies
Rehabilitation Centers
Risk Assessment
Risk Factors
Venous Thromboembolism / epidemiology,  prevention & control*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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