Venous Thromboembolism

Worel, Jane Nelson

doi:10.1097/jcn.0b013e3181b85c7b

Cited by 9 publications

(3 citation statements)

References 23 publications

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“…Other multifaceted intervention studies focusing on antibiotics found an increase in the rate of guideline adherence of antibiotic prescription [ 27 , 28 ]. The hypothesis that a multifaceted approach is the most effective method to improve protocol adherence is supported by a previous study of Worel et al [ 11 ] who described that lack of audit tools and feedback systems and the presence of an abundance of guidelines with conflicting recommendations result in lack of guideline adherence. Furthermore, passive dissemination of guidelines alone is often insufficient to have a positive impact on guideline adherence [ 13 ].…”

Section: Discussionmentioning

confidence: 91%

“…Studies evaluating partial and/or complete compliance with the American College of Chest Physicians (ACCP) venous thromboembolism (VTE) prevention guidelines, published between 2005 and 2008, showed that compliance rates ranged from 2.8 to 84% [ 11 ]. Proietti and colleagues assessed adherence in a cohort of atrial fibrillation (AF) acutely admitted patients.…”

Section: Introductionmentioning

confidence: 99%

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The effect of hospital-based antithrombotic stewardship on adherence to anticoagulant guidelines

et al. 2019

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Background Anticoagulant therapy is associated with a high risk of complications. Adherence to anticoagulant therapy protocols may lower this risk but adherence is often suboptimal. The introduction of a multidisciplinary antithrombotic team may improve adherence to anticoagulant guidelines among physicians. Objective To determine the effect of hospital-based multidisciplinary antithrombotic stewardship on adherence to anticoagulant guidelines among prescribing physicians. Setting This prospective non-randomised before-and-after study was conducted in patients hospitalized between October 2015 and December 2017 and treated with anticoagulant therapy. Method A multidisciplinary antithrombotic team focusing on education, medication reviews, drafting of local anticoagulant therapy protocols, patient counseling and medication reconciliation at admission and discharge was implemented in two Dutch hospitals. Main outcome measure Primary outcome was the proportion of the admitted patients in which the prescribing physician did adhere to the anticoagulant guidelines. Results The study comprised 1886 patients, of which 941 patients were included in the usual care period and 945 patients in the intervention period. Multivariable logistic regression analysis indicated that adherence was observed significantly more often during the intervention period (adjusted odds ratio [ORadj] 1.58, 95% confidence interval [95% CI] 1.21–2.05). Detailed analysis identified that the significantly higher overall adherence in the intervention period was attributed to dosing of LMWHs (odds ratio [OR] 1.58, 95% CI 1.16–2.14). Conclusion This study shows that introduction of a multidisciplinary antithrombotic stewardship leads to a significantly higher overall adherence to anticoagulant guidelines among prescribing physicians, mainly based on the improvement of dosing of low-molecular-weight-heparins. Electronic supplementary material The online version of this article (10.1007/s11096-019-00834-2) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 91%

Section: Introductionmentioning

confidence: 99%

The effect of hospital-based antithrombotic stewardship on adherence to anticoagulant guidelines

et al. 2019

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“…Differences in educational levels, inadequate resources, job discontent, lack of drive, and a smaller extent of higher training are some of the issues that play to barriers, as per Asemahagn (2014). Additionally, lack of enabling mechanisms, individual responsibility for implementation, lack of acceptance, perceived lack of necessity in particular therapeutic areas, lack of oversight or incentives, and contradicting guideline directions have all been noted as hurdles to guideline adherence (Worel, 2009).…”

Section: Discussionmentioning

confidence: 99%

Venous thromboembolism prophylaxis: Nurses' perceived knowledge and barriers

Alshammari¹,

Mostoles²,

Alharbi³

2023

Int. j. adv. appl. sci.

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Nurses, as primary healthcare providers who maintain regular patient contact, play a crucial role in preventing venous thromboembolism (VTE). This study aims to explore nurses' perceptions, knowledge, and barriers related to VTE prevention. A descriptive cross-sectional study was conducted among 263 staff nurses in governmental hospitals in the Hail region, Kingdom of Saudi Arabia. Data collection took place between January and May 2022. The majority of nurses considered VTE prevention to be an important issue (mean = 4.03±0.614) and perceived the current use of anticoagulant strategies as effective (mean = 2.91±1.16). However, nurses expressed some uncertainty regarding the safety of the current anticoagulant use (mean = 3.79±0.822) and felt that they underutilized available anticoagulant strategies (mean = 2.69±1.01). Generally, nurses demonstrated a good level of knowledge about VTE (83.2%). Gender was found to significantly influence knowledge (t = -2.841; p < 0.005), perception (t = -7.919; p < 0.000; mean = 3.85±0.707), and barriers (t = -4.661; p < 0.000). Regarding age, significant differences were observed in knowledge (F = 5.665; p < 0.004; mean = 15.87±4.39) and perception (F = 13.401; p < 0.000; mean = 4.16±0.782). No significant differences were found in educational attainment, work experience, and position concerning knowledge, perception, and barriers. The working area was found to have a significant impact on knowledge (F = 4.657; p < 0.000), perception (F = 4.347; p < 0.001), and barriers (F = 4.257; p < 0.001). By providing comprehensive and consistent patient education, nurses can play a critical role in minimizing morbidity and mortality rates associated with VTE, making VTE prevention a vital aspect of their responsibilities.

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Clinical Practice Guidelines

Graham¹

2014

Hand Clinics

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Venous Thromboembolism

Cited by 9 publications

References 23 publications

The effect of hospital-based antithrombotic stewardship on adherence to anticoagulant guidelines

The effect of hospital-based antithrombotic stewardship on adherence to anticoagulant guidelines

Venous thromboembolism prophylaxis: Nurses' perceived knowledge and barriers

Clinical Practice Guidelines

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