VTE Bundle Summary

It is imperative that all members of the care team are able to quickly and accurately communicate the patients’ condition and needs to other members of the care team. Proper communication allows for better monitoring of the patients’ condition and allows the providers and pharmacists to more accurately assess the patients’ treatment needs. The implementation of electronic medical records (EMR), as Nightingale Hospital is currently researching, has been shown to greatly improve care team communication and patient outcomes by allowing easy, verifiable access to all the patients’ records. Implementation of an EMR system will provide a necessary foundation for a great improvement in staff and provider communication, resulting in improved outcomes for all patients, including those undergoing anticoagulation therapy. Specifically regarding anticoagulation therapy, EMR will allow other care team members, including other nurses, providers and pharmacists’ one place to look for patient histories, allergies, lab and other results and monitor, potential drug interactions and adjust medication levels with regard to patient specific needs. EMR will also allow for more accurate medication administration through

The 2016 USPSTF guidelines for the prevention of CVD are highly credible and demonstrate a thorough evaluation of credible evidence and provided understandable and easily applied practice recommendations. The guidelines can be readily applied to a variety of health care settings and providers to promote the long-term health of their patients. Recent updates in 2016 ensure that the most evidence-based information has been applied in their formulation. Use of these guidelines will help reduce the risk of CVD while minimizing complications attributed to the

You are the nurse working in an anticoagulation clinic. K.N. is a patient who has a longstanding irregularly irregular heartbeat (atrial fi brillation, or A-fi b) for which he takes the oral anticoagulant warfarin (Coumadin). Recently, K.N. had his mitral heart valve replaced with a mechanical valve. You know that there are different PT/INR (prothrombin time/International Normalized Ratio) goal recommendations based on the indication for anticoagulation. (NOTE: PT has now been replaced by or is reported, in most cases, with INR [International Normalized Ratio], an international value that allows for laboratory standardization. PTT is more properly written

It is composed of actively practicing physicians, other prescribers, pharmacists, nurses, administrators, quality improvement managers, and other health care professionals and staff who participate in the medication-use process. The P&T committee should be responsible for overseeing policies and procedures related to all aspects of medication use within an institution. The P&T committee is responsible to the medical staff as a whole, and its recommendations are subject to approval by the organized medical staff as well as the administrative approval process. The P&T committee’s organization and authority should be outlined in the organization’s medical staff bylaws, medical staff rules and regulations, and other organizational policies as appropriate. Other responsibilities of the P&T committee include medication-use evaluation (MUE), adverse-drug-event monitoring and reporting, medication-error prevention, and development of clinical care plans and guidelines. The hospital’s internal policies follow all national standards for how the P&T committee should

The researchers sought out to understand the factors that contribute to the progression and limitation of guideline implementation within the primary health care setting. These emphasized guidelines are throughout the introduction portrayed as a positive implementation that will elevate the health care system as well as improve the assessment and management of cardiovascular risk. The adversity within these proposed implantations lie within their validity, such as which guidelines are effective and the reason for their effectiveness. The researchers also alluded to the efforts of New Zealand and their use of an Assessment and Management of

Many organizations have developed practice guidelines for a myriad of clinical scenarios which include the use of specific drugs or classes of medications, typically in a step-wise pattern. These “Best Practice” guidelines are built on evidence based criteria and systematic reviews. It has been shown that these clinical guidelines, with their list of essential medications, improve the quality of care and lead to better outcomes, but have not been shown to reduce costs.4,5 The practice of medicine has moved dramatically towards the use of these guidelines in recent years. For example, best practices for diabetic care recommends that all patients be placed on an ACE (angiotensin converting enzyme) inhibitor or ARB (angiotensin receptor blocker) for prevention of diabetic nephropathy and a statin for prevention of coronary artery disease. However, each patient’s insurance may cover a different medication in this class

Creating a program that uniformly reduces these complications is a significant advancement in quality of care, an improvement to patient health and satisfaction that is rewarded by government payment programs. With this in mind, CSC set out to develop and implement an ERAS pathway consistent enough to allow sustainable compliance regulation but flexible enough to suit a network with academic medical centers and community hospitals. Our goal was to design evidence based practice, reduce length of hospital stay, prevent post-op complications and readmissions, decrease SSI rate and improve financial burden associated with CMS payment programs including Value based purchasing and HAC reduction program. This pathway addressed hurdles of its forbears with a five-pronged approach. First, a systematic review of the literature was conducted to define the essential elements of a successful ERAS pathway and to understand the logistical hurdles faced by past implementation efforts. Second, a “grassroots” pathway was developed through consensus among stakeholders across Partners hospitals. Third, compliance was encouraged through a decision support scheme built directly into the EHR that was updated to reflect ERAS care decisions across providers. Fourth, the Partners Internal Performance Framework (IFP) was leveraged to encourage each site to develop its own sustainable workflow and regulatory body. Fifth, concise and diverse patient education materials were

Wednesday evening June 3, aboard the carrier Hornet, Lieutenant Commander John Waldron gathered the members of Torpedo Squadron 8 (VT-8) for a briefing. VT-8 was flying the obsolete 1930’s vintage Douglas Devastators torpedo planes. They had not received a lot of flight training in their ten months in the navy. Most members had never taken off of a carrier carrying a torpedo but just six weeks earlier they had watch Doolittle’s B-25 bombers take off the Hornet for the raid on Tokyo. If Doolittle’s pilots could take off in a bomber, the members of VT-8 could handle taking off with a torpedo. A Japanese task force was threatening Midway Island and a battle to stop them was expected to occur tomorrow. Waldron told them not to worry about navigation but to just follow him. Waldron finished his briefing by

Prevention Quality Indicators(PQI), POI “represent hospital admission rates for common ambulatory care-sensitive conditions”. This indicator is driven by early detection and limitation of severe disease. And these indicators can be used to recognize potential issues and focuses on preventive healthcare/services. For example, A patient was admitted to the hospital due to complications related to warfarin toxicity- elevated INR of 6.45. This indicator would suggest that if adequate teaching was provided, hospitalization may have been avoided if their PT/INR was monitored regularly as an outpatient.

Great post. The advantage of disseminating EBP knowledge, such as the use of chlorhexidine to prevent MRSA & VRE is huge. MRSA & VRE are some of the hospital acquired infection that is of huge cost to the hospitals because insurance companies will not pay for such treatment. In addition, the quality of care given to patients depends on how safe our patients entrusted to our care are (free of hospital acquired infection). I think the need to disseminate EBP knowledge should be encouraged to promote quality of care and reduce cost. In response, to your question about the use of PCAT, I would say that PCAT are overwhelmed because PCAT/patient ratio is higher than RN/patient ratio. Although, 2 hourly rounding may be adopted, I think patients’

Various studies has been presented many methods to prevent pulmonary embolism in high-risk patents which mostly focus on using of inferior vena cava filters, and anticoagulation. However, contradictory results are suggested within this research because only a certain type of inferior vena cava filters are examined, for example, prophylactic inferior vena cava filters. Dazley et al. (2012) shows the efficacy of propyl lactic IVC filters in preventing the development of venous thromboembolic event in patients undergoing surgery, while the other study proposes the different result. To understand how IVC filters and anticoagulation effect on high-risk patients. This paper study Dazley et al.’s (2012) research to express better understand how

medication administrations while decreasing the total time required for the initiation of this therapy. Therefore, the literature research for the best applicable evidence and translation of that evidence into practice is necessary to improve the quality of care. Upon careful review of various literature related to thrombolytic administration in acute care setting, two systemic reviews of randomized control trials (RCTs) and one quantitative quasi-experimental study have been selected to discuss the findings and their applicability into local practice.

Use of Pharmacological Thromboprophylaxis to Prevent Deep Vein Thrombosis in Medical-Surgical Patients: A Review of Current Literature

Studies suggest that cancer patients have a 4 to 7 fold increased risk of venous thromboembolism(VTE) compared to general population with an

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