Download or read book Implementation of a Standardized Protocol for the Identification and Treatment of Hospitalized Patients at Risk for Venous Thromboembolism written by Sharon L. Falke and published by . This book was released on 2011 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: There are nearly 900,000 cases of venous thromboembolism yearly in the United States with over 300,000 deaths, a figure that exceeds that of most other diseases. This incidence rate is echoed in global studies, with an acknowledged poor adherence to clinical practice guideline recommendations for the prevention of this serious hosptial-acquired condition. Venous thromboembolism is the primary patient safety concern for many of the health care regulating bodies, including the Centers for Medicare and Medicaid, National Quality Forum, and The Joint Commission. It has been recognized as the most preventable cause of hospital deaths; therefore, many insurance payers will limit reimbursement for the added cost of care required in the event of this complication. Arizona hospitals are in the median range when evalutated for compliance with the guideline recommendations and for initiating venous thromboembolism prophylaxis, with a moderate improvement noted in those partiicpating in more closely monitored programs. This capstone project was initiated at a small community hospital that initially had an abysmal rate of adherence with the prevention protocol, and seldom acknowledged the disease risk during patient assessments, with the goal of improvement in regulatory comliance and amelioration of patients safety with a reduction in morbidity and mortality. The theoretical foundation for this project was the Rosswurm and Larrabee conceptual model and the constructivism adult learner theory; additionally, protocols and an audit-feedback system were used as a reinforcement tool. This project was initiated as part of the admission process for inpatients, with each patient expected to be assessed for venous thromboembolism potential within 24 hours using the Caprini risk assessment model. The hospitalist clinicians were provded copies of the model along with the accompanying instruction tool during an educational briefing. Once they were aprised of the disease risks, patient benefits, regulatory requirements, and financial incentives, copies of the risk assessment tool were placed on each medical chart and at each dictation station as a reminder of the protocol. During the first month of this project evaluation, an improvement was noted in guideline adherence from 23% to over 59% of patients assessed for risk and of those found to be at risk, the percentage of patients actually receiving treatment increased from 31% to 77%, demonstrating significant improvement. The expected improvement outcome is 25% to 40% with the use of similar methods as this project. The primary adverse effect of chemoprophylaxis is hemorrhage; however there were no incidences of increased bleeding noted during this evaluation and three incidents of deep vein thrombosis in untreated patients, clearly illustrating the importance of this therapy. This project demonstrated the critical importance of recognizing the risk for thromboembolism, determining the appropriate therapy with consideration for confounding factors, and administering that therapy for an adequate time period. This project supports the recommendations of the clinical practice guidelines and the governmental regulations surrounding the issue, and provides the hospital with a framework for compliance with accreditation and regulating core measures.
Download or read book Acute Pulmonary Embolism written by A. Geibel and published by Springer Science & Business Media. This book was released on 2012-12-06 with total page 202 pages. Available in PDF, EPUB and Kindle. Book excerpt: The value of echocardiography in the diagnostic work-up of patients with suspected acute pulmonary embolism.- New developments in the thrombolytic therapy of venous thrombosis.- Mechanism of blood coagulation. Newer aspects of anticoagulant and antithrombotic therapy.MR-angiography in the diagnosis of pulmonary embolism.Scintigraphy-ventilation/perfusion scanning and imaging of the embolus.- Clinical course and prognosis of acute pulmonary embolism.- The molecular mechanisms of inherited thombophilia.
Download or read book Management of Acute Pulmonary Embolism written by Stavros V. Konstantinides and published by Springer Science & Business Media. This book was released on 2007-12-31 with total page 273 pages. Available in PDF, EPUB and Kindle. Book excerpt: This practical volume highlights traditional, novel, and evolving aspects of the diagnosis and treatment of pulmonary embolism (PE). The contributors comprise an international team of experts. Important aspects of diagnosis, risk stratification, and differential treatment of patients with PE are presented in a concise, yet comprehensive manner. Emphasis is placed on specific issues related to PE, including pregnancy, cancer, thrombophilia, and air travel.
Download or read book Implementing Change in the Prevention of DVT Through Standardization of Risk Assessment written by Sandra Davidson and published by . This book was released on 2013 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Research studies show hospitalized patients are at increased risk for venous thromboembolism (VTE) which is a frequently encountered serious and potentially fatal complication. VTE also referred to as deep vein thrombosis (DVT) is the formation of a blood clot or other form of emboli in in the deep veins, most commonly occurring in the lower extremities, usually deep within the calf, but they may also occur in the upper extremities and pelvic region and is the most common preventable cause of death that occurs in the hospital setting. Because studies have shown that the use of low molecular weight heparin (LMWH) significantly reduces the chance of developing DVTs while compression stockings and intermittent pneumatic compression (IPC) devices have been shown to be helpful in increasing circulation in the lower extremities, physicians are currently is the practice of ordering one, a combination of two, or all three of these preventative methods. Currently at Salem Health no standard of practice or policy is in place for determining the most appropriate method of DVT prophylaxis based on the individual patient's needs and/or risk factors. Therefore the question is this: Do patients need both the chemical therapy of LMWH and the mechanical IPC device therapy to prevent DVTs, is LMWH alone enough or would an individualized risk assessment tool be a better alternative for determining the appropriate intervention? Implementation of change in current unstandardized methods to a standardized evidence-based plan would incorporate the use of the Caprini risk assessment model (RAM) which evaluates the individual's needs by taking into consideration the patient's age, type of surgical procedure or trauma and the presence of other risk factors (Caprini,2005). Furthermore, by also making the RAM available to nurses as an educational resource to guide the physician/RN collaboration process improvement of patient safety and outcomes can undoubtedly be attained.
Download or read book Evidence Based Orthopedics written by Mohit Bhandari and published by John Wiley & Sons. This book was released on 2021-07-13 with total page 1184 pages. Available in PDF, EPUB and Kindle. Book excerpt: Evidence-Based Orthopedics is an up-to-date review of the best evidence for the diagnosis, management, and treatment of orthopedic conditions. Covering orthopedic surgery as well as pre- and post-operative complications, this comprehensive guide provides recommendations for implementing evidence-based practice in the clinical setting. Chapters written by leading clinicians and researchers in the field are supported by tables of evidence that summarize systematic reviews and randomized controlled trials. In areas where evidence is insufficient to recommend a practice, summaries of the available research are provided to assist in decision-making. This fully revised new edition reflects the most recent evidence using the approved evidence-based medicine (EBM) guidelines and methodology. The text now places greater emphasis on GRADE—a transparent framework for developing and presenting summaries of evidence—to allow readers to easily evaluate the quality of evidence and the strength of recommendations. The second edition offers a streamlined presentation and an improved standardized format emphasizing how evidence in each chapter directly affects clinical decisions. Incorporating a vast amount of new evidence, Evidence-Based Orthopedics: Features thoroughly revised and updated content, including a new chapter on pediatric orthopedics and new X-ray images Provides the evidence base for orthopedic surgery as well as pediatric orthopedics and orthopedic conditions requiring medical treatment Covers the different methods for most orthopedic surgical procedures, such as hip replacements, arthroscopy, and knee replacements Helps surgeons and orthopedic specialists achieve a uniform optimum standard through a condition-based approach Aligns with internationally accepted guidelines and best health economic principles Evidence-Based Orthopedics is an invaluable resource for orthopedic specialists, surgeons, trauma surgeons, trainees, and medical students.
Download or read book Cancer Associated Thrombosis written by Alok A. Khorana and published by CRC Press. This book was released on 2007-09-26 with total page 290 pages. Available in PDF, EPUB and Kindle. Book excerpt: Showcasing the expertise of top-tier specialists who contributed to the newly released guidelines for the care of thrombosis in cancer patients, this exciting guide was written and edited by members of the American Society of Clinical Oncology panel, (ASCO), on the prevention and treatment of cancer-associated thrombosis, among others, and provides
Download or read book Importance of the Use of a Venous Thromboembolism Assessment Tool to Identify and Prevent Venous Thromboembolis Events in the Hospitalized Patient written by Rebecca Geis and published by . This book was released on 2013 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: The venous thromboembolism is a growing concern for all patient care facilities in regards to patient safety and cost. According to documented studies, ninety-nine percent of all patients have at least one risk factor making them more susceptible to development of a venous thromboembolism (VTE) while being hospitalized (Sadler, 2011). Research shows with proper identification of risk factors appropriate prophylactic treatment can be prescribed to prevent the development of a VTE. Implementing the use of a mandatory VTE risk assessment tool to be performed by a predetermined employee can improve rates of prescribed prophylactic treatment and decrease incidence of the VTE from occurring. These interventions can conceivably increase patient safety and greatly reduce hospital costs. This paper will present readers with research confirming that the use of the VTE risk assessment tool is proven in increasing the amount of patients on prophylactic treatment. The author will explain the steps necessary in implementing the plan from trial runs to educating the staff. The evaluation of the tool will be addressed and the plan to get this plan out to the healthcare community is also discussed.
Download or read book Deep Vein Thrombosis and Pulmonary Embolism written by Edwin J. R. van Beek and published by John Wiley & Sons. This book was released on 2009-03-12 with total page 584 pages. Available in PDF, EPUB and Kindle. Book excerpt: Dedicated to dealing with a challenging disease, previously thought to be incurable, but with the advent of new drugs, now amenable to management and a much improved prognosis for patients. - Latest publication in a fast-moving area of keen clinical interest - Authored by leading international authorities - Builds on success of a respected first edition - Incorporates new data on latest imaging technologies and therapies - Covers both the science and clinical aspects, including presentation, surgical intervention and drug therapy - Includes coverage of both Pulmonary Embolism and Deep Vein Thrombosis
Download or read book Significance of Deep Vein Thrombosis Prophylaxis in Surgical Patients written by Lissette Leyva and published by . This book was released on 2014 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Based on documented studies, the prevalence rate of deep vein thrombosis (DVT) increases without the use of prophylactic measures in surgical patients. If not treated, DVT has the potential to lead to a venous thromboembolism (VTE), which can prove to be fatal. Research has indicated a significant problem that requires immediate attention in recognizing surgical patients who are at risk for DVT/VTE and treating them prophylactically before a problem even has the chance to begin. Not only has research shown that this is a significant issue in health care, it has also shown that it is an issue that is flying too low under medical staff's radar. Studies have shown a decrease in rate of DVT/VTE based on the use of appropriate assessment tools, risk screens, and treatment protocols. Mechanical and pharmacological interventions have shown to be safe and have positive impacts on surgical patient outcomes. Implementation of a standard policy for DVT/VTE prophylaxis and initiating treatment following established protocols and guidelines has the potential to decrease post-operative surgical patient complications, such as DVT/VTE, and improve patient outcomes. These interventions have the potential to educate medical staff, produce delivery of a higher quality of care, decrease length of hospital stay for patients, decrease the rate of DVT/VTE after surgery, and most importantly, save lives.
Download or read book Prominence of Prophylaxis to Prevent Venous Thromboembolism written by Sujitha Abraham and published by . This book was released on 2014 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Venous thromboembolism (VTE), which includes deep vein thrombosis (DVT) and pulmonary embolism (PE), is the prevalent hospital acquired cause of death based on research evidence. VTE affect 350,000 to 600,000 people yearly in the United States with death of 100,000 people a year (Baser, Supina, Sengupta, Wang and Kwong, 2010). Evidence-based research suggests that only 49% of patients are receiving prophylactic measures regardless of prophylactic guidelines. The consequences of VTE are mortality, morbidity, prolong duration of hospital stay, recurrent hospitalization, high Medicare cost, burden to health care, and affect the quality improvement of organization. The incidence of VTE and related issues can be prevented by proper use of mechanical and pharmacological measures alone or in combination with evidence-based guideline, which is effective and safe. The drawbacks of following the prophylactic guideline include knowledge deficit among health care providers on risk assessment tools, timely initiation of therapy, lack of motivation, noncompliance of patient and nurses, unavailability of resources, and lack of support from organization. A proposed plan is an implemented and evaluated outcome to increase awareness of prophylactic measures. Changed plan is supported and approved by stakeholders and disseminated to the nursing community. Researches showed that nurses have vital responsibility in inhibiting the incidence of VTE by early identification, proper risk assessment tool, patient and family education, timely initiation of appropriated treatment, advocating and collaborating with multidisciplinary team, and providing evidence-based care (Cawley, 2008). Different evidence-based approaches implemented on the new plan in the clinical setting are improving nurses and patient perception on treatment, knowledge, and compliance and assessing the barriers in present guideline. Methods used in the new plan are education session by audio-visual method, charts reviews by retrospective method, and conferences. In conclusion, the changed plan provided substantial improvement in VTE prevention, reduction in mortality, morbidity, high quality improvement, and cost effectiveness.
Download or read book Diagnosis and Management of Hypertrophic Cardiomyopathy written by Barry J. Maron and published by John Wiley & Sons. This book was released on 2008-04-15 with total page 527 pages. Available in PDF, EPUB and Kindle. Book excerpt: Diagnosis and Management of Hypertrophic Cardiomyopathy is aunique, multi-authored compendium of information regarding thecomplexities of clinical and genetic diagnosis, natural history,and management of hypertrophic cardiomyopathy (HCM)—the mostcommon and important of the genetic cardiovasculardiseases—as well as related issues impacting the health oftrained athletes. Edited by Dr. Barry J. Maron, a world authority on HCM, and withmajor contributions from all of the international experts in thisfield, this book provides a single comprehensive source ofinformation concerning HCM. Recent advances in the field arediscussed, including the importance of left ventricular outflowtract obstruction, the use of implantable defibrillators for theprevention of sudden death in young people, definition of thegenetic basis for HCM and its role in clinical diagnosis and riskstratification, the development of more precise strategies forassessing the level of risk for sudden death among all patientswith HCM, and the evolution of invasive interventions for heartfailure symptoms, such as surgical management and its alternatives(alcohol septal ablation and dual-chamber pacing). Key Features: Contributions from all experts in the field,representing diverse viewpoints regarding this heterogeneousdisease and related issues in athletes Information to dispel misunderstandings regarding issuesassociated with HCM and cardiovascular disease in athletes The only comprehensive source of information available on thetopic
Download or read book Textbook of Patient Safety and Clinical Risk Management written by Liam Donaldson and published by Springer Nature. This book was released on 2020-12-14 with total page 496 pages. Available in PDF, EPUB and Kindle. Book excerpt: Implementing safety practices in healthcare saves lives and improves the quality of care: it is therefore vital to apply good clinical practices, such as the WHO surgical checklist, to adopt the most appropriate measures for the prevention of assistance-related risks, and to identify the potential ones using tools such as reporting & learning systems. The culture of safety in the care environment and of human factors influencing it should be developed from the beginning of medical studies and in the first years of professional practice, in order to have the maximum impact on clinicians' and nurses' behavior. Medical errors tend to vary with the level of proficiency and experience, and this must be taken into account in adverse events prevention. Human factors assume a decisive importance in resilient organizations, and an understanding of risk control and containment is fundamental for all medical and surgical specialties. This open access book offers recommendations and examples of how to improve patient safety by changing practices, introducing organizational and technological innovations, and creating effective, patient-centered, timely, efficient, and equitable care systems, in order to spread the quality and patient safety culture among the new generation of healthcare professionals, and is intended for residents and young professionals in different clinical specialties.
Download or read book Trauma Induced Coagulopathy written by Hunter B. Moore and published by Springer Nature. This book was released on 2020-10-12 with total page 802 pages. Available in PDF, EPUB and Kindle. Book excerpt: The first edition of this publication was aimed at defining the current concepts of trauma induced coagulopathy by critically analyzing the most up-to-date studies from a clinical and basic science perspective. It served as a reference source for any clinician interested in reviewing the pathophysiology, diagnosis, and management of the coagulopathic trauma patient, and the data that supports it. By meticulously describing the methodology of most traditional as well as state of the art coagulation assays the reader is provided with a full understanding of the tests that are used to study trauma induced coagulopathy. With the growing interest in understanding and managing coagulation in trauma, this second edition has been expanded to 46 chapters from its original 35 to incorporate the massive global efforts in understanding, diagnosing, and treating trauma induced coagulopathy. The evolving use of blood products as well as recently introduced hemostatic medications is reviewed in detail. The text provides therapeutic strategies to treat specific coagulation abnormalities following severe injury, which goes beyond the first edition that largely was based on describing the mechanisms causing coagulation abnormalities. Trauma Induced Coagulopathy 2nd Edition is a valuable reference to clinicians that are faced with specific clinical challenges when managing coagulopathy.
Download or read book Anticoagulation Therapy written by Joe F. Lau and published by Springer. This book was released on 2018-04-16 with total page 464 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book presents the latest evidence and guidelines supporting the use of anticoagulant therapy for various clinical scenarios. The field of anticoagulation therapy is evolving rapidly, particularly since the arrival and widespread adoption of direct oral anticoagulants. Organized in two parts, this book reviews the pharmacologic properties of various anticoagulants and details the clinical applications of anticoagulant therapy. Drugs such as warfarin and unfractionated heparin, as well as parenteral and direct oral anticoagulants are discussed in terms of their pharmacokinetics, drug-disease interactions, dosing strategies, and risk considerations. Clinical applications of anticoagulant therapy in disorders such as acute coronary syndromes, atrial fibrillation, and thrombophilia and in special populations such as pregnant women, the elderly, and in the patient with cancer are highlighted. Clinical vignettes, algorithms, clinical pearls, and self-assessment questions are integrated throughout the book. Featuring contributions from authorities in the field, Anticoagulation Therapy is an essential resource for cardiologists, vascular medicine specialists, hematologists, internists, and all other healthcare professionals who prescribe anticoagulants.
Download or read book Making Health Care Safer written by and published by Department of Health and Human Services. This book was released on 2001 with total page 744 pages. Available in PDF, EPUB and Kindle. Book excerpt: "This project aimed to collect and critically review the existing evidence on practices relevant to improving patient safety"--P. v.
Download or read book Joint Arthroplasty written by Shinichi Imura and published by Springer Science & Business Media. This book was released on 2012-12-06 with total page 428 pages. Available in PDF, EPUB and Kindle. Book excerpt: The introduction of total joint arthroplasty throughout the world has contributed manifold benefits to patients who suffer from joint diseases. Concurrently, however, there has been an increase in revision surgery. Many orthopedic surgeons agree that durability of prostheses is an eternal problem. In particular, periprosthetic osteolysis recently has been identified as one of the serious problems affecting prosthetic dura bility. To improve durability, osteolysis and many other problems must be investi gated and solved both experimentally and clinically with respect to such aspects as prosthetic material, design, and biological and biomechanical behavior. This book comprises 37 papers that were presented by orthopedic surgeons and biomedical engineers at the 28th Annual Meeting of the Japanese Society for Replace ment Arthroplasty, held in March 1998 in Kanazawa, Japan. The volume is thus a compilation of the latest knowledge about the pathogenesis and reduction of osteolysis and wear, newly developed total hip prostheses, and other current topics of total knee arthroplasty. We earnestly hope that this book will be of benefit to clinicians and researchers, and that it will contribute to the creation of more durable total joint prostheses in the future. SHINICHI IMURA v Contents Preface .................... '" .. .. .. ... . .. .. .. . ... .. . . .. . ... . . .. . V List of Contributors. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . XI . . . . . . . . . . . . Part 1 Wear and Pathogenesis of Osteolysis Friction and Wear of Artificial Joints: A Historical Review N. AKAMATSU ................................................ , 3 Matrix Degradation in Osteoclastic Bone Resorption Under Pathological Conditions .
Download or read book Caring for People who Sniff Petrol Or Other Volatile Substances written by National Health and Medical Research Council (Australia) and published by . This book was released on 2011 with total page 33 pages. Available in PDF, EPUB and Kindle. Book excerpt: These guidelines provide recommendations that outline the critical aspects of infection prevention and control. The recommendations were developed using the best available evidence and consensus methods by the Infection Control Steering Committee. They have been prioritised as key areas to prevent and control infection in a healthcare facility. It is recognised that the level of risk may differ according to the different types of facility and therefore some recommendations should be justified by risk assessment. When implementing these recommendations all healthcare facilities need to consider the risk of transmission of infection and implement according to their specific setting and circumstances.
