J Clin Outcomes Manage
Venous thromboembolism prevention strategies in hospitalized patients
Lee JA, Zierler BK, Glenny RW, Wittkowsky AK, Servellen GV, Amin AN
Abstract: Objective: To provide an overview of venous thromboembolism (VTE) prevention strategies, including a review of current quality initiatives. Methods: A review of relevant journal articles and web sites related to VTE prevention and risk assessment was conducted. Results: VTE is a major source of morbidity and mortality world-wide and considered to be the most common preventable cause of hospital death. Evidence-based consensus guidelines on thromboembolic prophylaxis have been available internationally for decades, yet VTE prophylaxis is often underutilized or inappropriately used. Recommendations for VTE prophylaxis include early ambulation or education for low-risk patients and pharmacologic prophylaxis using anticoagulants for moderate- or high-risk patients. Mechanical prophylaxis measures are recommended for patients at high risk of bleeding as they are not eligible for pharmacologic prophylaxis. Systems approaches to improving VTE prophylaxis have been developed, and agencies have established quality measures to improve care of this condition. Conclusion: Health care organizations should ensure that all hospitalized patients receive VTE risk assessment upon admission and after a major event and that appropriate interventions for VTE prevention are taken. An evaluation of processes used in the assessment and prevention of VTE and subsequent clinical outcomes should be integrated with quality improvement and patient safety measures.
Clinical Review Article
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