Validation of a clinical guideline on prevention of venous thromboembolism in medical inpatients: a before‐and‐after study with systematic ultrasound examination

Labarère, José; Bosson, Jean‐Luc; Brion, Jean‐Paul; Fabre, Maria Emília de Souza; Imbert, B.; Carpentier, P.; Pernod, Gilles

doi:10.1111/j.1365-2796.2004.01365.x

Cited by 43 publications

(42 citation statements)

References 44 publications

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“…These studies generally show statistically significant increases in the proportion of patients receiving prophylaxis after the adoption of a QI strategy (Table 3). 13,[23][24][25][26][27][28][29][30] Provider Education…”

Section: Active Qi Strategiesmentioning

confidence: 99%

“…[26][27][28][29][30] A pharmacydriven educational program in a 493-bed US community hospital focusing on the importance of VTE prophylaxis in medically ill patients increased the use of prophylaxis from 43% to 58% (P<.001), of suitable prophylaxis from 38% to 49% (P=.006), and of optimal prophylaxis from 11% to 44% (P<.001). The educational program comprised live educational presentations and newsletters and involved nursing staff, house staff, pharmacists, and physicians.…”

Section: Active Qi Strategiesmentioning

confidence: 99%

“…Reminder posters can be used to reinforce information from educational sessions, 27,30 but the effectiveness of using this passive method alone has not been tested. An active reminder was a shared element of the most effective QI initiatives identified by Tooher et al 8 ; active reminders consist of either paper-based reminders or a computer-based alert.…”

Section: Provider Reminder and Decision Supportmentioning

confidence: 99%

“…8 However, computerized entry systems are not widespread, therefore decision support can take the form of pocket cards providing information on risk factors and prophylaxis options. 27,30 The provision of risk assessment or stratification, as well as prophylaxis, that is based on accepted guidelines is a consensus standard endorsed by the NQF/Joint Commission. Risk assessment models that address the needs of hospitalized surgical and medical patients, 34 ],or just medical patients have been developed.…”

Section: Provider Reminder and Decision Supportmentioning

confidence: 99%

“…7 In the Tooher et al review, most of the QI studies were performed in surgical patients. 8 However, several more recently published initiatives have focused on medical patients [26][27][28][29][30] (Table 3). A highly successful multifaceted strategy for improving appropriate VTE prophylaxis in medical patients combined education, dissemination of a decision support tool, and regular audit-and-feedback for resident physicians.…”

Section: Qi Initiatives For Preventing Vte In Surgical or Medical Patmentioning

confidence: 99%

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Bridging the Gap Between Evidence and Practice in Venous Thromboembolism Prophylaxis: The Quality Improvement Process

Michota

2007

J GEN INTERN MED

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Venous thromboembolism (VTE) is considered to be the most common preventable cause of hospital-related death. Hospitalized patients undergoing major Surgery and hospitalized patients with acute medical illness have an increased risk of VTE. Although there is overwhelming evidence for the need and efficacy of VTE prophylaxis in patients at risk, only about a third of those who are at risk of VTE receive appropriate prophylaxis. To address the shortfall in VTE prophylaxis, the US Joint Commission and the National Quality Forum (NQF) endorse standardized VTE prophylaxis practices, and are identifying and testing measures to monitor these standards. Hospitals in the USA accredited by Centers for Medicare and Medicaid Services to receive medicare patients will need VTE prophylaxis programs in place to conform to these national consensus standards. This review aims to give background information on initiatives to improve the prevention of VTE and to identify key features of a successful quality improvement strategy for prevention of VTE in the hospital. A literature review shows that the key features of effective quality improvement strategies includes an active strategy, a multifaceted approach, and a continuous iterative process of audit and feedback. Risk assessment models may be helpful for deciding which patients should receive prophylaxis and for matching VTE risk with the appropriate intensity of prophylaxis. This approach should assist in implementing the NQF/Joint Commission-endorsed standards, as well as increase the use of appropriate VTE prophylaxis.

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