Venous thromboembolism (VTE) represents both a significant health threat for at-risk patients and a financial burden. Meanwhile, provider organizations that fail to focus on and prevent VTE from occurring may be exposing themselves to quality-related reimbursement penalties by CMS.
Becker's Hospital Review recently spoke with two VTE prevention champions — Amy Campbell, PhD, quality lead nurse, and Jennifer Whaley, DNP, team lead IMCU and consult APC teams, cardiothoracic surgery — about the importance of implementing VTE prevention protocols for compliance and improved health outcomes.
Question: Each year, an estimated 350,000 to 600,000 patients are affected by VTE, resulting in approximately 100,000 deaths. Yet, about 70 percent of these VTE cases are preventable. What can clinicians do to effectively identify patients at risk for VTE?
Jennifer Whaley: Some things that clinicians often don't tend to think about that can put patients at higher risk happen in a setting in which the clinicians aren't involved in the patients' care — those are transient risk factors.
For example, if a patient has had any kind of anesthesia or surgery that lasted more than 30 minutes, even if it was just three months ago, and the patient gets admitted back into the hospital with pneumonia, what happened three months ago increases the patient's VTE risk. So, it's incredibly important to get as much health history as you can from your patients so that you can calculate their true risk.
Q: What can hospitals and health systems do to help clinicians detect VTE risk and take measures to prevent it?
Amy Campbell: Organizations should develop and follow protocols for when nurses should do VTE prophylaxis. These protocols should include what to do when patients refuse to wear sequential compression devices (SCDs) and when nurses should notify the provider. We have standardized our order sets and that helped a whole lot. You've got to think of system solutions — and protocols and order sets are system solutions.
Q: Are there additional steps that clinicians can take to reduce at-risk patients' likelihood of suffering VTE?
JW: Cardinal Health's Smart Compression™ system with customized Vascular Refill Detection and Patient Sensing™ Technology ensures that SCDs that embed this system are highly effective. The Smart Compression™ difference is in that it provides compression that moves more blood, which helps prevent stasis, and tracks compliance, so patients and clinicians are educated about the risk of VTE while also keeping the environment in mind.
Q: Can nurturing a more collaborative culture between providers help with VTE prevention efforts?
AC: When you have great nursing leadership, great physician leadership, a great person in charge of quality and a great nursing champion, you've got what I call the Four Musketeers. When you get that together, magic's going to happen.