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VTE Risk Assessment & Prophylaxis in OB

VTE Risk Assessment & Prophylaxis in OB. Engaging the Entire Clinical Team to Achieve QI Success. Today’s Panel. Ron Iverson, Moderator Ginny Combs, Nursing Marie Kourtelidis, Midwifery Rachel Shelley-Abrahamson, Medical Student Roxanne Handal-Orefice, OB Resident Emma Trucks, CME.

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VTE Risk Assessment & Prophylaxis in OB

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  1. VTE Risk Assessment & Prophylaxis in OB Engaging the Entire Clinical Team to Achieve QI Success

  2. Today’s Panel • Ron Iverson, Moderator • Ginny Combs, Nursing • Marie Kourtelidis, Midwifery • Rachel Shelley-Abrahamson, Medical Student • Roxanne Handal-Orefice, OB Resident • Emma Trucks, CME

  3. Project Aims: In-House Prophylaxis • To adopt new set of VTE risk assessment and prophylaxis guidelines and train all frontline providers on L&D by December 2015. • Increase the percentage of L&D admitted patients who have a VTE risk assessment documented to 80% by June 2016. • Increase the percentage of VTE risk assessment result documented in the patient’s problem list to 80% by June 2016. • Increase the percentage of high risk postpartum women receiving prophylactic enoxaparin in-house to 80% by June 2016 • Roll out a VTE Risk Assessment flowsheet and order set by July 2016.

  4. Project Aims: Discharge Prophylaxis • To discharge 90% of high-risk patients home from BMC on enoxaparin by September 2016. • To educate 100% of high-risk patients on self-administration of enoxaparin by September 2016. • For 60% of high-risk patients to report use of at least one dose of enoxaparin at home following discharge by September 2016. (Note: New aim – 90%!) • To train postpartum nursing staff on enoxaparin patient education by June 2016.

  5. Intervention Timeline Part 1

  6. Intervention Timeline Part 2

  7. % of pts w/ RA documented on Problem List Integration of Risk Assessment flowsheet and Connected Order Sets into EMR

  8. % of pts at High Risk for VTE

  9. % of high risk pts receiving prophylactic heparin during admission

  10. % of High Risk Pts who had LMWH prescribed at discharge Initiated Continuing Prophylaxis at Discharge PDSAs Integration of Risk Assessment flowsheet and Connected Order Sets into EMR

  11. % of Pts who received bedside education Initiated Continuing Prophylaxis at Discharge PDSAs

  12. % of Pts who reported picking up medication

  13. % of pts who injected at least one dose of Enoxaparin post discharge

  14. Breakdown of who administered injection at home

  15. Today’s Panel • Ron Iverson, Moderator • Ginny Combs, Nursing • Marie Kourtelidis, Midwifery • Rachel Shelley-Abrahamson, Medical Student • Roxanne Handal-Orefice, OB Resident • Emma Trucks, CME

  16. Questions? Ron Iverson, MD Ronald.Iverson@bmc.org

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