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Improving compliance to clinical practice guidelines with a multifaceted quality improvement program for the prevention of venous thromboembolic disease in nonsurgical patients
- Source :
- International journal for quality in health care : journal of the International Society for Quality in Health Care. 32(5)
- Publication Year :
- 2019
-
Abstract
- Objective To evaluate the change in compliance to thromboprophylaxis guidelines before and after the implementation of a multifaceted patient safety program. Design Longitudinal before and after study. Setting Teaching hospital, Hospital Universitario San Ignacio, Bogotá (Colombia). Participants Adult nonsurgical hospitalized patients. Intervention A multifaceted program for the prevention of venous thromboembolic (VTE) disease among adult nonsurgical hospitalized patients. The strategies of the program included (i) update and communication of thromboprophylaxis guidelines, (ii) the implementation of risk-assessment tools in electronic medical records, (iii) nursing staff activities and (iv) education to health personnel and patients for maintenance of the program. Main Outcome Measure Appropriate use of thromboprophylaxis. Results 221 and 236 patients were evaluated in the pre- and postimplementation periods, respectively. Global appropriate thromboprophylaxis prescription went from 74.66 to 82.6% (P = 0.064). Adequate thromboprophylaxis in high-risk patients did not increase significantly (77.70 vs 80.62%, P = 0.528), but a significant reduction in inappropriate thromboprophylaxis formulation in low-risk patients was found, decreasing from 20.55 to 5.26% (P = 0.005). Conclusions Implementing a quality improvement multifaceted program improves the formulation of adequate thromboprophylaxis. Reducing the inappropriate prescription of VTE prophylaxis in patients at low risk of thrombosis can lead to a reduction in bleeding complications and a better use of economic and human resources.
- Subjects :
- Adult
Male
medicine.medical_specialty
Nursing staff
Quality management
Inappropriate Prescribing
Disease
030204 cardiovascular system & hematology
Colombia
Risk Assessment
03 medical and health sciences
Patient safety
0302 clinical medicine
Medicine
Humans
030212 general & internal medicine
Medical prescription
Hospitals, Teaching
Aged
business.industry
Health Policy
Medical record
Public Health, Environmental and Occupational Health
Anticoagulants
General Medicine
Venous Thromboembolism
Middle Aged
medicine.disease
Thrombosis
Quality Improvement
Emergency medicine
Female
Guideline Adherence
Patient Safety
Risk assessment
business
Subjects
Details
- ISSN :
- 14643677
- Volume :
- 32
- Issue :
- 5
- Database :
- OpenAIRE
- Journal :
- International journal for quality in health care : journal of the International Society for Quality in Health Care
- Accession number :
- edsair.doi.dedup.....a029c0e11fb8db0b776324906a9bcf7b