Prevention of Venous Thromboembolism in Long Term Care: Results of a Multicenter Educational Intervention Using Clinical Practice Guidelines: Part 2 of 2 (an AMDA Foundation Project)

Dharmarajan, T. S.; Nanda, Aman; Agarwal, Bikash; Agnihotri, Parag; Doxsie, G.; Gokula, Murthy; Javaheri, Ashkan; Kanagala, M.; Lebelt, A.; Madireddy, Prasuna; Mahapatra, Sourya; Murakonda, P.; Muthavarapu, S. Ram Rao; Patel, Mennakshi; Patterson, Christopher; Soch, Kathleen; Troncales, Anna; Yaokim, Kamal; Kroft, Robin; Norkus, Edward P.

doi:10.1016/j.jamda.2011.04.015

Cited by 8 publications

(5 citation statements)

References 22 publications

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“…This study identified that most aged care providers' policy managers are unaware that VTE is an issue in the residential aged care population, though described thoroughly as such in the literature (Apenteng et al, 2017; Dharmarajan et al, 2012; Heit et al, 2016; Leibson et al, 2012; Reardon et al, 2013). The results demonstrate a lack of knowledge, as even when aware of VTE, the majority were not informed on current VTE risk screening and prophylaxis evidence.…”

Section: Discussionmentioning

confidence: 99%

“…However, similar data in Australian settings are lacking. The insidious nature of VTE supports risk assessment and implementation of thromboprophylaxis as the most cost‐effective management strategy in long‐term care settings (Dharmarajan et al, 2012; Geerts et al, 2008). Having appropriate VTE risk screening and management strategies for older at‐risk adults, particularly those in aged care settings, is pivotal to minimising patient complications and healthcare burdens.…”

Section: Introductionmentioning

confidence: 99%

“…VTE rates are substantially greater in aged care facility residents, relative to the general community (Apenteng et al, 2017). Established VTE risk factors for older adults, including frailty, obesity, hospitalisation, surgery, malignancy, trauma, fracture, heart failure, immobility, superficial vein thrombosis, dementia or hormone replacement therapy (Leibson et al, 2012) are also more prevalent in aged care residents (Dharmarajan et al, 2012; Gomes et al, 2003; Reardon et al, 2013). As the world's ageing population increases, VTE incidence rates are expected to rise exponentially (Fowkes et al, 2003; Heit et al, 2016).…”

Section: Introductionmentioning

confidence: 99%

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Venous thromboembolism risk screening, training and provider awareness in Australian residential aged care facilities

Karamacoska

Johnson

Harrison

et al. 2022

Health Social Care Comm

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Venous thromboembolism (VTE), including deep vein thrombosis and pulmonary embolism, globally affects 2-7 in every 1000 adults aged over 70 each year (Raskob et al., 2014). In Australia, it is a leading cause of morbidity and mortality (Economics, 2016), and costs the healthcare system $1.72 billion (AUD) annually (Commission, 2014). VTE rates are substantially greater in aged care facility residents, relative to the general community (Apenteng et al., 2017). Established VTE risk factors for older adults, including frailty, obesity, hospitalisation, surgery, malignancy, trauma, fracture, heart failure, immobility, superficial vein thrombosis, dementia or hormone replacement therapy (Leibson et al., 2012) are also more prevalent in aged care residents (Dharmarajan et al., 2012;Gomes et al., 2003;Reardon et al., 2013). As the world's ageing population increases, VTE incidence rates are expected to rise exponentially

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Venous thromboembolism risk screening, training and provider awareness in Australian residential aged care facilities

Karamacoska

Johnson

Harrison

et al. 2022

Health Social Care Comm

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“…The implementation of CPGs developed by AMDA has repeatedly been shown to make a positive impact on clinical outcomes among residents and can be implemented using the information provided [1][2][3][4]. The use of a champion to initiate the process and an implementation team is strongly recommended.…”

Section: Tricks Of the Trade For Cpg Implementationmentioning

confidence: 99%

The clinical practice guideline for falls and fall risk

Vance

2011

Behav. Med. Pract. Policy Res.

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Falling is a significant cause of injury and death in frail older adults. Residents in long-term care (LTC) facilities fall for a variety of reasons and are more likely to endure injuries after a fall than those in the community The American Medical Directors Association (AMDA) Clinical Practice Guideline is written to give LTC staff an understanding of risk factors for falls and provide guidance for a systematic approach to patient assessment and selection of appropriate interventions. It is intended to help facilities establish processes for evaluating, managing, and preventing falls. AMDA guidelines are written specifically for the elder in the LTC setting. Facility teams systematically address each individual's risk factors for falls and fall risks and the adverse consequences on the patient's functioning and quality of life. AMDA guidelines emphasize key care processes and are organized for ready incorporation into facility-specific policies and procedures to guide staff and practitioner practices and performance. KEYWORDSFalls, Fall risk, Elderly, Clinical practice guidelines, Long-term care, Fall, FallingFalling is a significant cause of injury and death in older adults, especially those who are frail. Residents in long-term care (LTC) facilities fall for a variety of reasons and are more likely to endure injuries after a fall than those living in the community. Among other things, decreased body weight and osteoporosis may result in serious injuries or fracture as a consequence of a fall. To help prevent and manage falls in long-term care settings, American Medical Directors Association (AMDA)-Dedicated to Long Term Care Medicine™ recently developed a Clinical Practice Guideline (CPG) for Falls and Fall Risk. Preventing falls with frail elders in this setting, many with cognitive problems, agerelated changes, chronic medical conditions, medication effects, and physical limitations is a significant challenge and requires dedicated interdisciplinary effort. AMDA stresses that goals should focus on minimizing fall risk and risk of fall-related injuries while maximizing individual dignity, freedom, and quality of life.The purpose of the guideline is to give LTC facility staff an understanding of intrinsic and extrinsic risk factors for falls and provide guidance for a timely and systematic approach to patient assessment and selection of appropriate interventions. In addition, it is intended to help facilities establish processes for evaluating, managing, and preventing falls.AMDA guidelines are written specifically for the elder in the LTC setting. AMDA believes that guidelines in the LTC setting should be consistent with fundamental goals of desirable LTC practice. Operationally, this requirement means that the nursing facility care team systematically addresses (1) each individual's risk factors for a number of diseases and conditions and (2) the adverse consequences of the diseases and conditions on the patient's functioning and quality of life. AMDA guidelines emphasize key care processes and are...

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“…A summary of the current literature (Table 1) shows that most available evidence primarily addressed the prescribing pattern of primary thromboprophylaxis in a nursing home population, serving at best as circumstantial evidence for the use of pharmacological VTE prevention. In multiple studies 11,12 evaluation of the adequacy of thromboprophylaxis prescription decisions was based on consensus or clinical practice guidelines aimed at hospitalized patients at risk for VTE. 13 This highlights the problem at hand; lack of awareness concerning the fact that nursing home residents cannot simply be compared to hospitalized patients in general.…”

mentioning

confidence: 99%

A known unknown? Pharmacological prevention of venous thromboembolism in nursing home residents

Brüggemann

Alnima

Brouns

et al. 2021

J American Geriatrics Society

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Prevention of Venous Thromboembolism in Long Term Care: Results of a Multicenter Educational Intervention Using Clinical Practice Guidelines: Part 2 of 2 (an AMDA Foundation Project)

Cited by 8 publications

References 22 publications

Venous thromboembolism risk screening, training and provider awareness in Australian residential aged care facilities

Venous thromboembolism risk screening, training and provider awareness in Australian residential aged care facilities

The clinical practice guideline for falls and fall risk

A known unknown? Pharmacological prevention of venous thromboembolism in nursing home residents

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