Simplifying Evidence-Based Venous Thromboembolism

The Quality and Safety Education for Nurses (QSEN) Institute developed six core competencies: patient-centered care, teamwork and collaboration, evidence-based practice, quality improvement, safety, and informatics (Quality and Safety Education for Nurses Institute, 2017). At my facility, it is clearly evident that they have adopted these six core competencies to improve patient quality and safety. My facility created the Office of Patient Experience which supports care that is safe, of high quality and high value. Patient satisfaction is a top priority which is why our guiding principle is known as “Patients First”. Through teamwork and collaboration, we deliver care that is patient-centered by working together in multidisciplinary rounds on the inpatient units. Also, the nursing education department supports quality, safety and consistent nursing care through a database of policies and procedures developed using evidence-based research. Lastly, the nursing informatics department is working towards making our EPIC system more patient-centered. They are doing this by decreasing the redundancy in charting for the nursing staff and finding ways to improve processes which automate tasks. This in turn will reduce the time that the nursing staff spends with their computer and increase the time that the nursing staff can spend with their patients.

They are tasked to encourage and facilitate EBP projects. This is one way of actively supporting, promoting and continuing to improve patient outcomes with the use of evidence-based practices. Challenges arise when there are no consistent leadership in this SL group that may be due to personal reasons, schedule challenges and the different challenges that may come during the steps in conducting the EBP project itself. In my personal experience on the EBP project on bedside handoff, the advantages and benefits of changing from nurse-to-nurse handoff at the nurses’ station to bedside handoff were emphasized to all stakeholders, including the increase in patient satisfaction when patients are involved in their care. However, we faced a high push-back form staff when it came to the implementation phase. There were concerns that handoff would be longer than usual, and that breech of patient confidentiality and privacy would ensue if bedside handoff was done. Despite all that, the bedside handoff EBP was successfully implemented mostly due to the timing and adequacy of staff education that included role playing, as well as strong support of the leadership team. According to Adams, Farrington and Cullen (2012), “The final and perhaps most intimidating step in the evidence-based practice (EBP) process is dissemination.” But with proper preparation, this can be

Venous thromboembolism refers to the formation of a blood clot in a blood vessel. While clots can form in an artery or a vein, this article focuses only on clots that occur in a vein ("," 2015). Critically ill patients are at an increased risk of a venous thromboembolism (VTE) due to VTE can manifest as a deep venous thrombosis (DVT) or a pulmonary embolism (PE). Risk factors include venous stasis, vascular injury, and hypercoagulable disorders. A majority of ICU patients carry at least one risk factor for VTE; additional risk factors are considered to have a cumulative effect…it is impossible to predict which patients will experience a

As a nurse leader at Optum, suggesting strategies to achieve quality and safety improvement in health care requires critical thinking, analysis of health care trends, and collaborative relationships (Grossman & Valiga, 2012). This collaborative professional relationship requires a blame-free environment for a successful safety culture (Agency for Healthcare Research and Quality [AHRQ], 2016). As Optum strives to

A process was designed by Ascension Health to eliminate preventable injuries and deaths within five years by the identification of causes to patient harm. They worked to define best practices and use them to improve these areas of patient safety by creating a structure for continuous improvement. A Clinical Excellence Team was put together to help guide the pursuits of the goal. Prototype strategies were put together at eight volunteer or alpha sites. These sites were chosen based on past performance for leading quality improvement. No mention was made regarding financial resources except that organizational members recognize the business case supporting the changes (“Case Study,” 2006).

There are many people that suffer from venous thromboembolism. Venous thromboembolism includes both deep vein thrombosis and pulmonary embolism. This is the third most common cause of vascular death after a myocardial infarction, also known as a heart attack, and stroke. This article examines the possibility of either full or low intensity anticoagulation therapy versus aspirin. This was a randomized study that consisted of 3,396 individuals who have venous thromboembolism. These individuals either received rivaroxaban, which is an anticoagulant, or 100 mg of aspirin once a day. The individuals in this study completed 6-12 months of anticoagulation therapy and were eligible for inclusion in the study if they were 18 years of age or older. The

Konstantinides, S., & Goldhaber, S. (2012). Pulmonary embolism: Risk assessment and management. European Heart Journal, 33(24), 3014-3022.

In order to improve the quality of care, all disciplines involve in patient care should be able to participate in quality improvement programs. “Opportunities are inherent in each of our individual work environments for championing the benefits of teamwork and dynamic cooperation, which can be exploited to benefit patient care and improve population health.” (Tetteh, 2012, p. 106). In order to focus on one problem for the purpose of this paper, risk for fall comes to mind the most in emergency department. As it was mentioned before, different departments work with each patient at ED such as laboratory, diagnostics, nurses, technicians, physicians, and many others. As a nurse, I witnessed many times that different employee provided care for patients and left patients’ bed in a high position. In many cases, patients were either confused related to the acute illness or under influence of narcotics. At those conditions, many patients do not use the call light to seek help getting out of bed which puts them at a very high risk for fall. Also, in many other occasions, patients’ call lights were not even within their reach or their beds were not locked after they came back from different tests. Patients’ fall causes many problems for health care system including patient injury, higher cost

Patient safety and quality care is the center of every health care provider’s initiatives. According to the Institute of Medicine (IOM) report “To Err is Human”, adverse events and medical errors happen at an alarming rate with approximately 400,000 deaths a year (Epps & Levin, 2015). An evidence-based practice, team strategies and tools to enhance performance and patient safety (TeamSTEPPS), is a comprehensive program that brings staff together to train and enhance patient safety initiatives (Epps & Levin, 2015). The purpose of this paper is to determine the tools teams use to improve patient safety while incorporating teams’ strategies to provide quality care and how this applies to the

Natural language processing of radiology reports for the detection of thromboembolic diseases and clinically relevant incidental findings

The scores might have shown to be more favorable if all of the nurses had completed the entire questionnaire, but due to the fact that several were not completely filled out the scores for those particular questionnaires deemed to be inconclusive and could not be counted. Based on these findings the researchers suggested that all nurses regardless of their personal characteristics should receive some type of educational training in evidence based practices. Having the use of this training will be beneficial and will cut down enormously on future outbreaks of VAPS to patients that are in ICU units. The reason for this synapsis is because the traditional methodology grading scale is less than favorable and needs to be upgraded with evidence-based

I believe that I have accomplished this course outcome in my practice because I understand the importance of patient safety and have taken necessary measures to ensure that I provide care that is evidence based and safe to my patients. One instance of how I do this is by utilizing SBAR when calling the doctors for orders, as well as during end of shift report to other nurses. I have also participated in initiating a fall prevention program for the safety of our residents that are highly at risks for falls. During the meeting, everyone was able to bring suggestions to the table, and agreed on implementing a device that is safe, more effective to prevent falls in our aging patients. As stated by Keller et. al (2013) “The quality of patient care is improved when members of the health care team work in collaboration to share their unique patient care perspectives.” Keeping in mind that healthcare involves different disciplines that equally participates daily in patient’s care, it is vital to set in place an effective form of communication that is sufficient to provide a safe and quality of care for an optimal patient outcome.” Effective teamwork balances unity with diversity.” (Hood, 2016, p.473). As a leader, implementation of this course outcome would necessitate educating the staff on patient safety measures, such as fall risk assessments and interventions, utilizing the stat response team and initiative to avoid medication errors. Promoting the use of patient care technology will also safeguard patients and act as a quality improvement

As the proportions of the aging U.S. population increases, more people are susceptible to venous thromboembolism (VTE) that often contribute to prolonged hospitalization, health complications, disability, poor quality of life, and premature death. This increase in VTE-related deaths and health complications has threatened the health and the economy of the U.S. society. Health care professionals need to make a better decision in preventing VTE, especially with the rise of new oral anticoagulants. Therefore, this integrative review discusses the effectiveness of Rivaroxaban, a new oral anticoagulant, versus Enoxaparin, a standard therapy, in preventing the occurrence of VTE thus reducing the nation’s

Venous thrombosis and arterial thrombosis are considered to be distinct pathophysiological processes due to their evident anatomical variances. With one having to deal with platelet activation while the other involving the clotting system activation, arterial thrombosis and venous thrombosis are similar yet vastly different when it comes to the processes that are performed for the body. These same processes that help the body have to be performed accordingly or the signs and symptoms begin to show. For instance, venous thrombosis can lead to Chronic Venous Insuffiency and other issues when a body part is congested. This is most commonly causes by valvular incompetence in the low-pressure superficial venous system; however, it can also be causes

Several studies have demonstrated use of tPA in massive or sub-massive pulmonary embolism to accelerate lysis of thrombi in patients presenting with sustained right ventricular dysfunction or circulatory collapse. Even though systemic tPA is the mainstay therapy, catheter directed techniques can also be employed in patients in severely critical condition or who have significant bleeding risk.