Editor’s note: Our understanding of COVID-19 symptomatology is evolving as the current pandemic unfolds. The International Society on Thrombosis and Haemostasis has collected a number of studies and case reports on thrombosis in COVID-19 patients. The Journal of American College of Cardiology released a review of current understanding, citing many of the studies and case reports which are on the ISTH site. This COVID-19 pandemic challenges us to use current knowledge and innovate new approaches to care for patients diagnosed with COVID-19. This article seeks to summarize some of the current knowledge about thrombosis in COVID-19 patients, knowing that future studies and case reports will undoubtedly refine the statements made below. However, this is science, continually evolving and improving based on current understanding. With that, this article offers some insights about VTE in patients admitted to the hospital who have been diagnosed with COVID-19.
By Michael Wong (Founder/Executive Director, Physician-Patient Alliance for Health & Safety), Laurie Paletz, BSN PHN RN BC SCRN (Manager, Stroke Program Department of Neurology, Cedars-Sinai), and Thereza B. Ayad, RN, MSN, DNP, CNOR (Assistant Professor, University of Massachusetts Medical School-Graduate School of Nursing; Surgical Services Clinical Staff Educator, North Shore Medical Center)
(reviewed by Sue Koob, MPA, Chief Executive Officer, Preventive Cardiovascular Nurses Association and Pat Salber, MD, MBA, Editor-in-Chief, DoctorWeighsIn)
Patient advocates and leading medical societies involved in awareness building and improving patient safety in Atrial Fibrillation (Afib) and venous thromboembolism (VTE) gathered recently for the 1st Annual Anticoagulation Summit, a two-day conference.
Michael Wong, JD, founder and Executive Director of the Physician-Patient Alliance for Health & Safety (PPAHS), presented a poster on the OB VTE Safety Recommendations, which were released by PPAHS, in collaboration with the Institute for Healthcare Improvement and the National Perinatal Association. The recommendations, compiled by a panel of health experts, give clinicians a step-by-step checklist to help assess all OB patients’ risks for VTE and identify the appropriate prophylaxis regimen to improve health outcomes for maternal patients. Read More
This week’s must reads focus on patient safety tools.
This week in #patientsafety, PPAHS announced our position that all patients receiving opioids must be monitored with capnography. From around the web, the American Journal of Nursing summarized venous thromboembolism (blood clots) guidelines from American College of Chest Physicians, Ontario released a dataset and tool to explore opioid-related morbidity and mortality, and Pain Medicine News discussed a researcher’s exploration of alternatives to opioids. Read More
We’re saying “hello” to December, and looking back at some of PPAHS’ top posts and tweets in November.
This month, as part of our new campaign targeting VTE in orthopedic patients, PPAHS was invited to become a partner of World Thrombosis Day! We also provided bittersweet coverage regarding opioid safety, including celebrating St. Joseph’s/Candler Health System’s (SJ/C) 12-years event-free and opioid safety’s place – once again – on ECRI’s Top 10 Health Technology Hazards. Read More
The following is an excerpt of an article on bundled payments for joint replacement written by Michael Wong, JD, Executive Director of PPAHS and Lynn Razzano, RN, MSN, ONCC, Clinical Nurse Consultant at PPAHS. It was first appeared on The Doctor Weighs In on November 18, 2016. To read the full article, please click here.
In October, the PPAHS celebrated it’s 5th anniversary. In addition to building around the growing body of knowledge regarding accounting for OSA in patients receiving opioids, the PPAHS also announced a new campaign targeting VTE in orthopedic patients. Read More
This week in patient safety news, we featured a guest post article on pre-op screening and assessment for OSA. We also found some great articles addressing the ICU, the opioid crisis, and the latest in wearable monitor studies. Read More
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.
The risk of blood clots in pregnant mothers is almost ten times more likely than a non-pregnant woman.
To help prevent blood clots in pregnant mothers, the Physician-Patient Alliance for Health & Safety (PPAHS) has released a web-enabled application of the OB VTE Safety Recommendations. The OB VTE application can be found at http://recommendations.ppahs.org/account/login Read More
Mother fell into a coma due to a blood clot that broke loose during an emergency C-section.
This might have been the headline last September, when 23-year-old nursing student Shelly Cawley experienced complications during labor that resulted in an emergency c-section and left her in a coma: Read More