The guidelines for preventing VTE after total joint arthroplasty (such as, knee and hip replacement) by the Academy of Orthopaedic Surgeons and American College of Chest Physicians are unanimous – both pharmacological and mechanical prophylaxis are needed.
The AAOS recommends the use of pharmacological and/or mechanical compression devices for both total hip arthroplasty (THA) and total knee replacement (TKA) patients who are not at an elevated risk for VTE or bleeding, as well as for patients with a known bleeding disorder and/or active liver disease.
PPAHS will be beginning a new #patientsafety campaign to develop practical solutions to help assess and prevent venous thromboembolism (VTE) in patients undergoing orthopedic procedures, particularly total knee and hip replacement. More commonly known as blood clots, VTE consists of both deep vein thrombosis (DVT) and pulmonary embolisms (PE) .
In the past, we have focused on the issue of VTE regarding maternal patients and stroke patients. In collaboration with panels of international health experts, PPAHS has developed the OB VTE Safety Recommendations and the Stroke VTE Safety Recommendations (both of which are free resources on our website). Members of the panel included:
- Atul Gawande, MD, MPH (Brigham and Women’s Hospital)
- Peter J. Pronovost, MD, PhD, FCCM (Johns Hopkins Medicine)
- Mark Alberts, MD, FAHA (Southwestern Medical Center)
- Irene Katzan, MD, MS (Cleveland Clinic)
- William M. Callaghan, MD, MPH (CDC)
- Frank Federico, RPh (Patient Safety Advisory Group, The Joint Commission)
- Mary D’Alton, MD (Columbia University Medical Center)
According to the CDC, VTE is estimated to affect 900,000 Americans annually. It is a preventable, hospital-acquired condition that is responsible for 100,000 deaths each year. The US Department of Health & Human Services (HHS) has also issued a statement identifying venous thromboembolism as the third most prevalent factor accounting for readmission 30-days after surgery (6.3%).
Hip and knee replacement operations are among the most commonly performed procedures in the U.S. About 1 million of these procedures are performed each year (for more on prevalence, see the study by Hilal Maradit-Kremers, MD, MSc et al, “Prevalence of Total Hip (THA) and Total Knee (TKA) Arthroplasty in the United States”). The 30-day readmission rate following hip and knee replacement is 4.3% and 3.9% respectively, with the readmission rate rising to 7.8% 90-days after surgery.
Join us in our fight to prevent orthopedic venous thromboembolism (VTE).
Over the next few months, we will be putting together an expert patient safety panel on orthopedic VTE to advise and help answer healthcare reporters’ questions, looking for interviewees for Patient Safety Podcasts (such as the series created in collaboration with the Society of Hospital Medicine), and for guest contributions to our blog.
First, our apologies to Nike – we would like to use the phrases “Just Do It” and “Just Don’t Do It” to sum up this week’s must reads: Read More
Our must reads for this week focus on 5 key tips, which if followed, could save a life.
As well, if you tweet about patient safety, a big “thank you” – see if your name appears below in our retweet shout outs. Read More
Presenting at a standing-room-only meeting at the recent International Stroke Conference (ISC), health experts recommended shortened door-to-treatment times and the use of intermittent pneumatic compression (IPC) to help prevent deep vein thrombosis (DVT) and pulmonary embolism (PE) in stroke patients. Read More
Guidelines Poised to Change Standard of Care for Stroke Treatment and Help Caregivers Lower Incidences of Venous Thromboembolism (VTE) in Ischemic and Hemorrhagic Stroke Patients Read More
Of the more than 125 articles we posted in 2014, below are eight of the most read and most discussed articles on blood clots (order is by publication date): Read More
Good news and bad news.
Yes, there have been other things going on in healthcare other than Ebola-mania … thanks @sacbee_news for this illustration putting Ebola in perspective:
The Good News
First, we’ll start with the good news, because most people love a celebration. Read More
Lynn Razzano, RN, MSN, ONCC, clinical nurse consultant with Physician-Patient Alliance for Health and Safety, recently spoke with Outpatient Surgery about preventing deep vein thrombosis and pulmonary embolism during the perioperative process for same-day surgery patients. Read More
By Lynn Razzano RN, MSN, ONCC (Clinical Nurse Consultant)
That’s the bottom line of a report from the Healthcare Management Council (HMC). HMC analyzed federal data to identify the most common hospital-acquired conditions (HACs) as well as their annual cost per patient and the annual average cost to hospitals. Read More