Tami Minnier on Preventing VTE

by: Tami Minnier,  Chief Quality Officer of UPMC and Executive Director for the Beckwith Institute

Pulmonary embolism (PE) and deep vein thrombosis (DVT), collectively known as Venous Thromboembolism (VTE), represent a major public health problem that affects 350,000 to 600,000 Americans. VTE is primarily a problem of sick or injured inpatients and is estimated to be among the most common preventable causes of hospital death.

Risk of VTE among hospitalized patients varies based on several risk factors including medical condition, type of surgery, trauma, cancer, age, immobility, hypercoagulable state, and previous history of VTE.

The use of a well-designed process and protocol that link risk assessment to appropriate actions can help prevent VTE. A process is a series of actions or steps taken to prevent VTE. Such a process could include the use of standard “orders” in the electronic record, such as post-operative orders addressing VTE prophylaxis.  A protocol is helpful to provide consistent real-time actions for every patient.

VTE protocol could include ambulating patients as soon as possible, administering blood thinners, and the use of sequential compression devices (SCDs). Blood-thinning medication is vital despite a patient’s ability to sit or walk. It is important that caregivers are educated about both the process and protocol so they can educate their patients.

We must keep the following key points in the forefront of our practice so that VTE prevention becomes a part of what we do every day for our patients. Here is a simple list of crucial points to remember:

  • Assess each patient’s VTE risk upon admission, transfer, and discharge.
  • Perform VTE screenings before other assessments like bedsores, risk of falls, and nutritional evaluation.
  • Educate patients and caregivers about their risk of VTE.
  • Identify specialty considerations or risk factors, for example, a diagnosis of cancer.
  • Administer anticoagulation prophylaxis as ordered.
  • Ensure sequential compression devices (SCDs) are worn as much as possible.
  • Ambulate patients early and often.

The results of increasing awareness of the risks of VTE include harm reduction and fewer preventable deaths. What could be better for us to strive for this year?

Here is an example of caregiver education.

Additional Resources 

Check out our APSS Blueprints for more information!