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DVT occurs when an abnormal blood clot forms inside a vein deep in the leg. DVT may cause leg pain and/or swelling but is often clinically silent. PE occurs when all or part of a DVT breaks away from its site in a vein and travels through the venous system to lodge in the lungs. PE may cause chest pain, shortness of breath, tachycardia, hemoptysis, or pre-syncope but is often clinically silent. 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DVT occurs when an abnormal blood clot forms inside a vein deep in the leg. DVT may cause leg pain and/or swelling but is often clinically silent. PE occurs when all or part of a DVT breaks away from its site in a vein and travels through the venous system to lodge in the lungs. PE may cause chest pain, shortness of breath, tachycardia, hemoptysis, or pre-syncope but is often clinically silent. In clinical practice, about two-thirds of VTE episodes manifest as DVT and one-third as PE with or without DVT (Nicholson, et al., 2020).  ",{"type":15,"attrs":370,"content":371},{"textAlign":53},[372],{"text":373,"type":303},"About 50 per cent of all VTE events occur because of a current or recent hospital admission for surgery or acute medical illness. Hospital-acquired VTE is preventable, with interventions including anticoagulants and mechanical measures, including compression stockings and intermittent pneumatic compression (Schünemann et al., 2018). In addition, VTE remains an important cause of maternal morbidity and mortality in Canada with an overall incidence of DVT and PE of 12.1 per 10,000 and 5.4 per 10,000 pregnancies, respectively. VTE occurs at a rate of 4.3 per 10,000 pregnancies postpartum (Chan et al., 2014).",{"type":335,"attrs":375,"content":376},{"level":337,"textAlign":53},[377],{"text":378,"type":303},"Risk Factors",{"type":15,"attrs":380,"content":381},{"textAlign":53},[382],{"text":383,"type":303},"Risk factors for VTE can be subdivided into factors that promote venous stasis, factors that promote blood hypercoagulability, and factors causing endothelial injury or inflammation. A clear understanding of the risk factors for VTE is vital to identify patients at risk of VTE who would benefit from thromboprophylaxis. An individual patient's risk of VTE depends on intrinsic, patient-specific factors (such as genetic risk factors, age, or body mass index) and acquired risk due to the unique context or situation (such as hospitalization, surgery, cancer, or pregnancy). Risk factors are also frequently categorized by \"transient vs. persistent\" and \"major vs. minor\" (Nicholson et al., 2020; Chan et al., 2014).",{"type":335,"attrs":385,"content":386},{"level":337,"textAlign":53},[387],{"text":388,"type":303},"Importance to Patients and Families",{"type":15,"attrs":390,"content":391},{"textAlign":53},[392],{"text":393,"type":303},"Hospital-acquired VTE (blood clots) is preventable (Schünemann et al., 2018).",{"type":15,"attrs":395,"content":396},{"textAlign":53},[397],{"text":398,"type":303},"One of the most important things you can do to prevent blood clots is to know if you are at risk. Some risk factors are hospitalization, surgery, pregnancy, or cancer. 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He was perfect, the delivery was pretty easy, and I was ready to go home. During a brief moment of quiet during his nap, I perused through the endless literature provided by the hospital. A hand drawing of a leg, with a red mark and arrow pointing to the calf describing deep vein thrombosis (DVT) struck me. I had a weird Charley horse in my leg, right in the same spot, but I thought it was no big deal. I mentioned it to the nurse, and we decided it was harmless. I went home with my bundle of joy. (Stop the Clot, nd).",{"type":15,"attrs":468,"content":469},{"textAlign":53},[470],{"text":471,"type":303,"marks":472},"Maury Lieberman's story",[473],{"type":350,"attrs":474},{"href":475,"uuid":53,"anchor":53,"custom":476,"target":460,"linktype":461},"https://www.stoptheclot.org/about-clots/cancer-and-blood-clots/",{},{"type":15,"attrs":478,"content":479},{"textAlign":53},[480],{"text":481,"type":303},"Maury Lieberman, National Blood Clot Alliance (NBCA) Board member, discusses his experience with cancer and blood clots: (Stop the Clot, 2015) Video","simple-richtext","wysiwyg-program",{"_uid":485,"items":486,"title":862,"component":863,"description":864},"9e5befbf-06c9-4f16-9ebf-b0f37018e5a4",[487],{"_uid":488,"title":489,"ctaLeft":490,"ctaRight":491,"component":492,"columnLeft":493,"columnRight":509},"4bef2000-2854-460d-9022-8e0436e83838","Expand to see a full list of resources",[],[],"accordion-item-columns",{"type":12,"content":494},[495],{"type":15,"attrs":496,"content":497},{"textAlign":53},[498,500,507],{"text":499,"type":303},"To develop a more in-depth understanding of the care delivered to patients, chart audits, incident analyses and prospective analyses can be helpful in identifying quality improvement opportunities. Links to key resources for conducting chart audits and analysis methods are included in the ",{"text":501,"type":303,"marks":502},"Hospital Harm Improvement Resource Introduction",[503],{"type":350,"attrs":504},{"href":352,"uuid":353,"anchor":53,"custom":505,"target":355,"linktype":356,"story":506},{},{"name":347,"id":358,"uuid":353,"slug":359,"url":360,"full_slug":360,"_stopResolving":361},{"text":508,"type":303},".",{"type":12,"content":510},[511,516,860],{"type":15,"attrs":512,"content":513},{"textAlign":53},[514],{"text":515,"type":303},"If your review reveals that your cases of VTE are linked to specific processes or procedures, you may find these resources helpful:",{"type":400,"content":517},[518,541,595,678,708,736,764,793,806,834,847],{"type":403,"content":519},[520,532],{"type":15,"attrs":521,"content":522},{"textAlign":53},[523,525],{"text":524,"type":303},"American Society of Clinical Oncology 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",{"text":686,"type":303,"marks":687},"isth.org",[688],{"type":350,"attrs":689},{"href":690,"uuid":53,"anchor":53,"custom":691,"target":460,"linktype":461},"http://isth.org",{},{"type":400,"content":693},[694,701],{"type":403,"content":695},[696],{"type":15,"attrs":697,"content":698},{"textAlign":53},[699],{"text":700,"type":303},"Full list of Published Guidance - International Society on Thrombosis and Haemostasis, Inc. (isth.org)",{"type":403,"content":702},[703],{"type":15,"attrs":704,"content":705},{"textAlign":53},[706],{"text":707,"type":303},"Spyropoulos, A.C., Levy, J.H., Ageno, W., Connors, J.M., Hunt, B.J., Iba, T., Levi, M., Samama, C.M., Thachil, J., Giannis, D., Douketis, J.D. and (2020), Scientific and Standardization Committee Communication: Clinical Guidance on the Diagnosis, Prevention and Treatment of Venous Thromboembolism in Hospitalized Patients with COVID‐19. J Thromb Haemost. Author Accepted Manuscript. ",{"type":403,"content":709},[710,721],{"type":15,"attrs":711,"content":712},{"textAlign":53},[713,715],{"text":714,"type":303},"Journal of Clinical Medicine ",{"text":716,"type":303,"marks":717},"https://www.mdpi.com/journal/jcm",[718],{"type":350,"attrs":719},{"href":716,"uuid":53,"anchor":53,"custom":720,"target":460,"linktype":461},{},{"type":400,"content":722},[723],{"type":403,"content":724},[725],{"type":15,"attrs":726,"content":727},{"textAlign":53},[728,730],{"text":729,"type":303},"Nicholson M, Chan N, Bhagirath V, Ginsberg, J. Prevention of Venous Thromboembolism in 2020 and Beyond. J. Clin. Med. 2020, 9, 2467-2494. ",{"text":731,"type":303,"marks":732},"https://www.mdpi.com/2077-0383/9/8/2467",[733],{"type":350,"attrs":734},{"href":731,"uuid":53,"anchor":53,"custom":735,"target":460,"linktype":461},{},{"type":403,"content":737},[738,749],{"type":15,"attrs":739,"content":740},{"textAlign":53},[741,743],{"text":742,"type":303},"Plos One ",{"text":744,"type":303,"marks":745},"https://journals.plos.org/plosone/",[746],{"type":350,"attrs":747},{"href":744,"uuid":53,"anchor":53,"custom":748,"target":460,"linktype":461},{},{"type":400,"content":750},[751],{"type":403,"content":752},[753],{"type":15,"attrs":754,"content":755},{"textAlign":53},[756,758],{"text":757,"type":303},"A systematic review of clinical practice guidelines on the use of low molecular weight heparin and fondaparinux for the treatment and prevention of venous thromboembolism: Implications for research and policy decision-making - ",{"text":759,"type":303,"marks":760},"https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0207410",[761],{"type":350,"attrs":762},{"href":759,"uuid":53,"anchor":53,"custom":763,"target":460,"linktype":461},{},{"type":403,"content":765},[766,778],{"type":15,"attrs":767,"content":768},{"textAlign":53},[769,771],{"text":770,"type":303},"Society of Obstetricians and Gynaecologists of Canada ",{"text":772,"type":303,"marks":773},"www.sogc.org",[774],{"type":350,"attrs":775},{"href":776,"uuid":53,"anchor":53,"custom":777,"target":460,"linktype":461},"http://www.sogc.org",{},{"type":400,"content":779},[780],{"type":403,"content":781},[782],{"type":15,"attrs":783,"content":784},{"textAlign":53},[785,787],{"text":786,"type":303},"Clinical Practice Guidelines: Venous thromboembolism and antithrombotic therapy in pregnancy. J Obstet Gynaecol Can. 2014; 36 (6): 527–553. ",{"text":788,"type":303,"marks":789},"https://www.jogc.com/article/S1701-2163(15)30569-7/fulltext",[790],{"type":350,"attrs":791},{"href":788,"uuid":53,"anchor":53,"custom":792,"target":460,"linktype":461},{},{"type":403,"content":794},[795],{"type":15,"attrs":796,"content":797},{"textAlign":53},[798,800],{"text":799,"type":303},"Stop the Clot. ",{"text":801,"type":303,"marks":802},"https://www.stoptheclot.org/",[803],{"type":350,"attrs":804},{"href":801,"uuid":53,"anchor":53,"custom":805,"target":460,"linktype":461},{},{"type":403,"content":807},[808,819],{"type":15,"attrs":809,"content":810},{"textAlign":53},[811,813],{"text":812,"type":303},"The Lancet Oncology ",{"text":814,"type":303,"marks":815},"https://www.thelancet.com/journals/lanonc/home",[816],{"type":350,"attrs":817},{"href":814,"uuid":53,"anchor":53,"custom":818,"target":460,"linktype":461},{},{"type":400,"content":820},[821],{"type":403,"content":822},[823],{"type":15,"attrs":824,"content":825},{"textAlign":53},[826,828],{"text":827,"type":303},"2019 international clinical practice guidelines for the treatment and prophylaxis of venous thromboembolism in patients with cancer ",{"text":829,"type":303,"marks":830},"https://www.sciencedirect.com/science/article/pii/S1470204519303365?casa_token=wR071dAWhlkAAAAA:IbnuYnSXaD97RZBGMYSFzAJK90a0l9H5EPGD4mwzgakl1qcvD4ali4tXgdHPr0bkc3jRFbxkZD4",[831],{"type":350,"attrs":832},{"href":829,"uuid":53,"anchor":53,"custom":833,"target":460,"linktype":461},{},{"type":403,"content":835},[836],{"type":15,"attrs":837,"content":838},{"textAlign":53},[839,841],{"text":840,"type":303},"Thrombosis Canada. ",{"text":842,"type":303,"marks":843},"http://thrombosiscanada.ca/",[844],{"type":350,"attrs":845},{"href":842,"uuid":53,"anchor":53,"custom":846,"target":460,"linktype":461},{},{"type":403,"content":848},[849],{"type":15,"attrs":850,"content":851},{"textAlign":53},[852,854],{"text":853,"type":303},"World Thrombosis Day. ",{"text":855,"type":303,"marks":856},"http://www.worldthrombosisday.org/",[857],{"type":350,"attrs":858},{"href":855,"uuid":53,"anchor":53,"custom":859,"target":460,"linktype":461},{},{"type":15,"attrs":861},{"textAlign":53},"Clinical and System Reviews, Incident Analyses","accordion-2-columns",{"type":12,"content":865},[866,878,884],{"type":15,"attrs":867,"content":868},{"textAlign":53},[869,871,876],{"text":870,"type":303},"Given the broad range of potential causes of ",{"text":872,"type":303,"marks":873},"VTE",[874],{"type":875},"italic",{"text":877,"type":303},", in addition to recommendations listed above, we recommend conducting clinical and system reviews to identify latent causes and determine appropriate recommendations.",{"type":15,"attrs":879,"content":881},{"textAlign":880},"left",[882],{"text":883,"type":303},"Occurrences of harm are often complex with many contributing factors. Organizations need to:",{"type":885,"attrs":886,"content":888},"ordered_list",{"order":887},1,[889,896,903,910],{"type":403,"content":890},[891],{"type":15,"attrs":892,"content":893},{"textAlign":53},[894],{"text":895,"type":303},"Measure and monitor the types and frequency of these occurrences.",{"type":403,"content":897},[898],{"type":15,"attrs":899,"content":900},{"textAlign":53},[901],{"text":902,"type":303},"Use appropriate analytical methods to understand the contributing factors.",{"type":403,"content":904},[905],{"type":15,"attrs":906,"content":907},{"textAlign":53},[908],{"text":909,"type":303},"Identify and implement solutions or interventions that are designed to prevent recurrence and reduce risk of harm.",{"type":403,"content":911},[912],{"type":15,"attrs":913,"content":914},{"textAlign":53},[915],{"text":916,"type":303},"Have mechanisms in place to mitigate consequences of harm when it occurs.",{"_uid":918,"items":919,"title":955,"component":956,"description":957},"3299f4e2-5248-4c98-ac38-ed0ab4e064a2",[920,931,939,947],{"_uid":921,"image":922,"title":926,"component":927,"description":928},"db9fdb12-8e66-4274-a99b-276e7c441dc5",{"id":923,"alt":16,"name":16,"focus":16,"title":16,"source":16,"filename":924,"copyright":16,"fieldtype":289,"meta_data":925,"is_external_url":277},119537678778928,"https://a-ca.storyblok.com/f/850807391887861/600x600/c301964117/checkmark-icon.png",{},"You may use different measures or modify the measures described below to make them more appropriate and/or useful to your particular setting. However, be aware that modifying measures may limit the comparability of your results to others.","small-text-image-item",{"type":12,"content":929},[930],{"type":15},{"_uid":932,"image":933,"title":935,"component":927,"description":936},"3eb5659d-5a90-4d22-9a12-a5a0b9a55a9a",{"id":923,"alt":16,"name":16,"focus":16,"title":16,"source":16,"filename":924,"copyright":16,"fieldtype":289,"meta_data":934,"is_external_url":277},{},"Evaluate your choice of measures in terms of the usefulness of the final results and the resources required to obtain them; try to maximize the former while minimizing the latter.",{"type":12,"content":937},[938],{"type":15},{"_uid":940,"image":941,"title":943,"component":927,"description":944},"97ccaf2a-b041-44d0-979e-3aff3e35571c",{"id":923,"alt":16,"name":16,"focus":16,"title":16,"source":16,"filename":924,"copyright":16,"fieldtype":289,"meta_data":942,"is_external_url":277},{},"Whenever possible, use measures you are already collecting for other programs.",{"type":12,"content":945},[946],{"type":15},{"_uid":948,"image":949,"title":951,"component":927,"description":952},"0417ee0d-76a8-4183-8e36-8f8dacbaf3eb",{"id":923,"alt":16,"name":16,"focus":16,"title":16,"source":16,"filename":924,"copyright":16,"fieldtype":289,"meta_data":950,"is_external_url":277},{},"Try to include both process and outcome measures in your measurement scheme.",{"type":12,"content":953},[954],{"type":15},"Measures","small-text-image",{"type":12,"content":958},[959],{"type":15,"attrs":960,"content":961},{"textAlign":53},[962],{"text":963,"type":303},"Vital to quality improvement is measurement, and this applies specifically to implementation of interventions. The chosen measures will help to determine whether an impact is being made (primary outcome), whether the intervention is actually being carried out (process measures), and whether any unintended consequences ensue (balancing measures). In selecting your measures, consider the following:",{"_uid":965,"items":966,"title":1169,"component":863,"description":1170},"dadb33a7-4880-4a5e-8a14-c2b4de6e7b8a",[967,1005,1088],{"_uid":968,"title":969,"ctaLeft":970,"ctaRight":971,"component":492,"columnLeft":972,"columnRight":991},"31e457d3-6058-4d7e-a4b9-81feb110d495","Selection Criteria",[],[],{"type":12,"content":973},[974,979],{"type":15,"attrs":975,"content":976},{"textAlign":53},[977],{"text":978,"type":303},"I80.1, I80.2, I82.2, I82.8, I82.9",{"type":15,"attrs":980,"content":981},{"textAlign":53},[982,984,989],{"text":983,"type":303},"Identified as diagnosis type (2) ",{"text":985,"type":303,"marks":986},"OR",[987],{"type":988},"bold",{"text":990,"type":303}," Identified as diagnosis type (3) AND T80.1, T81.7, T82.8, T83.8, T84.8 or T85.8 as diagnosis type (2) AND Y60–Y84 in the same diagnosis cluster",{"type":12,"content":992},[993,998,1003],{"type":15,"attrs":994,"content":995},{"textAlign":53},[996],{"text":997,"type":303},"O87.102, O87.902",{"type":15,"attrs":999,"content":1000},{"textAlign":53},[1001],{"text":1002,"type":303},"Identified as diagnosis type (M), (1), (2), (W), (X) or (Y)",{"type":15,"attrs":1004},{"textAlign":53},{"_uid":1006,"title":1007,"ctaLeft":1008,"ctaRight":1009,"component":492,"columnLeft":1010,"columnRight":1014},"af053a57-4d50-43ab-9d01-2ae90201306a","Codes & Code Descriptions",[],[],{"type":12,"content":1011},[1012],{"type":15,"attrs":1013},{"textAlign":53},{"type":12,"content":1015},[1016,1025,1034,1043,1052,1061,1070,1079],{"type":15,"attrs":1017,"content":1018},{"textAlign":53},[1019,1023],{"text":1020,"type":303,"marks":1021},"I26.–",[1022],{"type":988},{"text":1024,"type":303},": Pulmonary Embolism",{"type":15,"attrs":1026,"content":1027},{"textAlign":53},[1028,1032],{"text":1029,"type":303,"marks":1030},"I80.1",[1031],{"type":988},{"text":1033,"type":303},": Phlebitis and thrombophlebitis of femoral vein",{"type":15,"attrs":1035,"content":1036},{"textAlign":53},[1037,1041],{"text":1038,"type":303,"marks":1039},"I80.2",[1040],{"type":988},{"text":1042,"type":303},": Phlebitis and thrombophlebitis of other deep vessels of lower extremities",{"type":15,"attrs":1044,"content":1045},{"textAlign":53},[1046,1050],{"text":1047,"type":303,"marks":1048},"I82.2",[1049],{"type":988},{"text":1051,"type":303},": Embolism and thrombosis of vena cava",{"type":15,"attrs":1053,"content":1054},{"textAlign":53},[1055,1059],{"text":1056,"type":303,"marks":1057},"I82.8",[1058],{"type":988},{"text":1060,"type":303},": Embolism and thrombosis of other specified veins",{"type":15,"attrs":1062,"content":1063},{"textAlign":53},[1064,1068],{"text":1065,"type":303,"marks":1066},"I82.9",[1067],{"type":988},{"text":1069,"type":303},": Embolism and thrombosis of unspecified vein",{"type":15,"attrs":1071,"content":1072},{"textAlign":53},[1073,1077],{"text":1074,"type":303,"marks":1075},"O87.102",[1076],{"type":988},{"text":1078,"type":303},": Deep phlebothrombosis in the puerperium; delivered with mention of postpartum complication",{"type":15,"attrs":1080,"content":1081},{"textAlign":53},[1082,1086],{"text":1083,"type":303,"marks":1084},"O87.902",[1085],{"type":988},{"text":1087,"type":303},": Venous complication in the puerperium, unspecified; delivered with mention of postpartum complication",{"_uid":1089,"title":1090,"ctaLeft":1091,"ctaRight":1092,"component":492,"columnLeft":1093,"columnRight":1097},"3815f9aa-f903-4480-b024-f0168d3c0de3","Additional codes & inclusions",[],[],{"type":12,"content":1094},[1095],{"type":15,"attrs":1096},{"textAlign":53},{"type":12,"content":1098},[1099,1108,1117,1126,1135,1144,1153],{"type":15,"attrs":1100,"content":1101},{"textAlign":53},[1102,1106],{"text":1103,"type":303,"marks":1104},"T80.1",[1105],{"type":988},{"text":1107,"type":303},": Vascular complications following infusion, transfusion, and therapeutic injection",{"type":15,"attrs":1109,"content":1110},{"textAlign":53},[1111,1115],{"text":1112,"type":303,"marks":1113},"T81.7",[1114],{"type":988},{"text":1116,"type":303},": Vascular complications following a procedure, not elsewhere classified",{"type":15,"attrs":1118,"content":1119},{"textAlign":53},[1120,1124],{"text":1121,"type":303,"marks":1122},"T82.8",[1123],{"type":988},{"text":1125,"type":303},": Other specified complications of cardiac and vascular prosthetic devices, implants, and grafts",{"type":15,"attrs":1127,"content":1128},{"textAlign":53},[1129,1133],{"text":1130,"type":303,"marks":1131},"T83.8",[1132],{"type":988},{"text":1134,"type":303},": Other complications of genitourinary prosthetic devices, implants, and grafts",{"type":15,"attrs":1136,"content":1137},{"textAlign":53},[1138,1142],{"text":1139,"type":303,"marks":1140},"T84.8",[1141],{"type":988},{"text":1143,"type":303},": Other complications of internal orthopaedic prosthetic devices, implants, and grafts",{"type":15,"attrs":1145,"content":1146},{"textAlign":53},[1147,1151],{"text":1148,"type":303,"marks":1149},"T85.8",[1150],{"type":988},{"text":1152,"type":303},": Other complications of internal prosthetic devices, implants, and grafts, not elsewhere classified",{"type":15,"attrs":1154,"content":1155},{"textAlign":53},[1156,1160,1162],{"text":1157,"type":303,"marks":1158},"Y60–Y84",[1159],{"type":988},{"text":1161,"type":303},": Complications of medical and surgical care (refer to Appendix A) of the ",{"text":1163,"type":303,"marks":1164},"Hospital Harm Indicator General Methodology Notes",[1165],{"type":350,"attrs":1166},{"href":1167,"uuid":53,"anchor":53,"custom":1168,"target":460,"linktype":461},"https://www.cihi.ca/sites/default/files/document/hospital-harm-indicator-general-methodology-notes.pdf",{},"Discharge Abstract Database",{"type":12,"content":1171},[1172,1181],{"type":15,"attrs":1173,"content":1174},{"textAlign":53},[1175,1177],{"text":1176,"type":303},"Discharge Abstract Database (DAD) Codes included in this clinical category: ",{"text":1178,"type":303,"marks":1179},"A06: Venous Thromboembolism",[1180],{"type":988},{"type":15,"attrs":1182,"content":1183},{"textAlign":53},[1184],{"text":1185,"type":303},"Concept: Embolism, thrombosis, phlebitis or thrombophlebitis of the pulmonary vein or other veins (excluding superficial veins) identified during a hospital stay.",{"_uid":1187,"content":1188,"component":483},"0498f131-9047-4876-8011-5cc6627a5c7d",[1189],{"_uid":1190,"content":1191,"component":482},"f69da5a4-5088-4153-9a28-4f1786dd1baa",{"type":12,"content":1192},[1193,1198,1208,1213,1218,1223,1228],{"type":335,"attrs":1194,"content":1195},{"level":337,"textAlign":53},[1196],{"text":1197,"type":303},"Success Stories",{"type":15,"attrs":1199,"content":1200},{"textAlign":53},[1201],{"text":1202,"type":303,"marks":1203},"Getting patients on board with VTE prophylaxis",[1204],{"type":350,"attrs":1205},{"href":1206,"uuid":53,"anchor":53,"custom":1207,"target":460,"linktype":461},"https://acphospitalist.acponline.org/archives/2019/02/success-story-getting-patients-on-board-with-vte-prophylaxis.htm",{},{"type":15,"attrs":1209,"content":1210},{"textAlign":53},[1211],{"text":1212,"type":303},"A bundle to educate patients about venous thromboembolism (VTE) included a 10-minute video of patients' stories and in-person support from a nurse educator.",{"type":15,"attrs":1214,"content":1215},{"textAlign":53},[1216],{"text":1217,"type":303},"Where: The Johns Hopkins Hospital, a 1,000-bed academic medical center in Baltimore.",{"type":15,"attrs":1219,"content":1220},{"textAlign":53},[1221],{"text":1222,"type":303},"The issue: Administering venous thromboembolism (VTE) prophylaxis as prescribed.",{"type":15,"attrs":1224,"content":1225},{"textAlign":53},[1226],{"text":1227,"type":303},"Background: Hospitalists know the importance of medications for VTE prophylaxis, but 12.7 per cent of prescribed doses were not administered in a study of 75 patients at Johns Hopkins Hospital, published in March 2018 by the American Journal of Health-System Pharmacy. Because the most commonly cited reason for non-administration was patient refusal, the Johns Hopkins VTE Collaborative decided to tackle the problem with patient education.",{"type":15,"attrs":1229,"content":1230},{"textAlign":53},[1231],{"text":1232,"type":303},"\"Our first step was to ask patients what they wanted to learn,\" said Elliott R. Haut, MD, PhD, vice chair of quality, safety, and service in the department of surgery at Johns Hopkins Medicine. After collecting patient input, the research group developed a patient education bundle composed of a two-page form about blood-clot prevention, a 10-minute video of patients' stories (shown on a hospital tablet, the TV, or a patient's personal device), and in-person support from a nurse educator... (Frost, 2019)",{"_uid":1234,"items":1235,"title":1369,"component":863,"description":1370},"8f469937-0182-47b8-84cd-a1d2c0b30303",[1236],{"_uid":1237,"title":1238,"ctaLeft":1239,"ctaRight":1240,"component":492,"columnLeft":1241,"columnRight":1245},"94e94b00-4b60-4be2-978a-e9450a9c6ce1","Expand to see a full list of references",[],[],{"type":12,"content":1242},[1243],{"type":15,"attrs":1244},{"textAlign":53},{"type":12,"content":1246},[1247],{"type":400,"content":1248},[1249,1258,1267,1274,1290,1305,1318,1327,1341,1355],{"type":403,"content":1250},[1251,1256],{"type":15,"attrs":1252,"content":1253},{"textAlign":53},[1254],{"text":1255,"type":303},"Canadian Patient Safety Institute (CPSI). Global Patient Safety Alerts. www.globalpatientsafetyalerts.com",{"type":15,"attrs":1257},{"textAlign":53},{"type":403,"content":1259},[1260,1265],{"type":15,"attrs":1261,"content":1262},{"textAlign":53},[1263],{"text":1264,"type":303},"Chan WS, Rey E, Kent NE, VTE in Pregnancy Guideline Working Group, et al. Society of Obstetricians and Gynaecologists of Canada (SOGC) Clinical Practice Guidelines: Venous thromboembolism and antithrombotic therapy in pregnancy. J Obstet Gynaecol Can. 2014; 36 (6): 527–553. http://sogc.org/guidelines/venous-thromboembolism-antithrombotic-therapy-pregnancy/",{"type":15,"attrs":1266},{"textAlign":53},{"type":403,"content":1268},[1269],{"type":15,"attrs":1270,"content":1271},{"textAlign":53},[1272],{"text":1273,"type":303},"Frost M. American College of Physicians. Getting patients on board with VTE prophylaxis. ACP Hospitalist Success Story, February 2019. https://acphospitalist.org/archives/2019/02/success-story-getting-patients-on-board-with-vte-prophylaxis.htm",{"type":403,"content":1275},[1276,1288],{"type":15,"attrs":1277,"content":1278},{"textAlign":53},[1279,1281],{"text":1280,"type":303},"Institute for Healthcare Improvement (IHI). How-to Guide: Prevent Harm from High-Alert Medications. Cambridge, MA: IHI; 2012. Available at ",{"text":1282,"type":303,"marks":1283},"www.ihi.org",[1284],{"type":350,"attrs":1285},{"href":1286,"uuid":53,"anchor":53,"custom":1287,"target":460,"linktype":461},"http://www.ihi.org",{},{"type":15,"attrs":1289},{"textAlign":53},{"type":403,"content":1291},[1292,1303],{"type":15,"attrs":1293,"content":1294},{"textAlign":53},[1295,1297],{"text":1296,"type":303},"National Blood Clot Alliance - About Clots, retrieved January 2021. ",{"text":1298,"type":303,"marks":1299},"https://www.stoptheclot.org/about-clots/",[1300],{"type":350,"attrs":1301},{"href":1298,"uuid":53,"anchor":53,"custom":1302,"target":460,"linktype":461},{},{"type":15,"attrs":1304},{"textAlign":53},{"type":403,"content":1306},[1307,1316],{"type":15,"attrs":1308,"content":1309},{"textAlign":53},[1310,1311],{"text":729,"type":303},{"text":731,"type":303,"marks":1312},[1313],{"type":350,"attrs":1314},{"href":731,"uuid":53,"anchor":53,"custom":1315,"target":460,"linktype":461},{},{"type":15,"attrs":1317},{"textAlign":53},{"type":403,"content":1319},[1320,1325],{"type":15,"attrs":1321,"content":1322},{"textAlign":53},[1323],{"text":1324,"type":303},"Schünemann HJ, Cushman M, Burnett AE, Kahn SR, Beyer-Westendorf J, Spencer FA, et al. (2018). American Society of Hematology 2018 guidelines for management of venous thromboembolism: prophylaxis for hospitalized and nonhospitalized medical patients. Blood Advances, 2, 3198-3225. https://doi.org/10.1182/bloodadvances.2018022954, 10.1182/bloodadvances.2018022954",{"type":15,"attrs":1326},{"textAlign":53},{"type":403,"content":1328},[1329,1339],{"type":15,"attrs":1330,"content":1331},{"textAlign":53},[1332,1334],{"text":1333,"type":303},"Stop the clot – Cancer and Blood Clots. Maury Lieberman's Experience. Video, 2015: ",{"text":475,"type":303,"marks":1335},[1336],{"type":350,"attrs":1337},{"href":475,"uuid":53,"anchor":53,"custom":1338,"target":460,"linktype":461},{},{"type":15,"attrs":1340},{"textAlign":53},{"type":403,"content":1342},[1343,1353],{"type":15,"attrs":1344,"content":1345},{"textAlign":53},[1346,1348],{"text":1347,"type":303},"Stop the clot – Patient Story. How A Drawing Saved My Life: Lori's Story. (retrieved January 2021) Full Text: ",{"text":458,"type":303,"marks":1349},[1350],{"type":350,"attrs":1351},{"href":458,"uuid":53,"anchor":53,"custom":1352,"target":460,"linktype":461},{},{"type":15,"attrs":1354},{"textAlign":53},{"type":403,"content":1356},[1357,1367],{"type":15,"attrs":1358,"content":1359},{"textAlign":53},[1360,1362],{"text":1361,"type":303},"Stop the clot – Prevent Blood Clots. (retrieved January 2021) ",{"text":801,"type":303,"marks":1363},[1364],{"type":350,"attrs":1365},{"href":801,"uuid":53,"anchor":53,"custom":1366,"target":460,"linktype":461},{},{"type":15,"attrs":1368},{"textAlign":53},"References",{"type":12,"content":1371},[1372],{"type":15},{"id":16,"_uid":1374,"items":1375,"component":1403},"6eb4e51c-bf24-41b1-9d59-7bad51888e07",[1376],{"_uid":1377,"link":1378,"image":1390,"title":1394,"component":1395,"description":1396},"53576ed1-d241-4755-a3d6-be730772819e",[1379],{"_uid":1380,"link":1381,"label":1388,"component":1389},"e0217179-bbaa-4d57-b4e5-70649fe00704",{"id":1382,"url":16,"linktype":356,"fieldtype":1383,"cached_url":1384,"story":1385},"e810da59-1dac-470d-a9fa-5791fc96027f","multilink","resources/topics/hospital-harm",{"name":1386,"id":1387,"uuid":1382,"slug":9,"url":1384,"full_slug":1384,"_stopResolving":361},"Hospital Harm",147250689243354,"See all resources","simple-link",{"id":1391,"alt":16,"name":16,"focus":16,"title":16,"source":16,"filename":1392,"copyright":16,"fieldtype":289,"meta_data":1393,"is_external_url":277},121293076058734,"https://a-ca.storyblok.com/f/850807391887861/2068x1484/1aea4e8fb2/senior-woman-holding-doctors-hand.webp",{},"Hospital Harm Resources","image-text-colored-item",{"type":12,"content":1397},[1398],{"type":15,"attrs":1399,"content":1400},{"textAlign":53},[1401],{"text":1402,"type":303},"Healthcare Excellence Canada has developed Hospital Harm Improvement Resources – a compilation of resources to support patient safety and improvement efforts.","image-text-colored",[115,143,122,129,136,150,157],[185,192,200],"hec-page-resource-single","venous-thromboembolism","resources/venous-thromboembolism",-18930,[],103604225865405,"5ae9abc6-19aa-407f-a12e-60e29f3c3669","2025-12-09T20:06:32.766Z","default",[],[1417],{"path":1418,"name":1419,"lang":1420,"published":361},"ressources/thrombo-embolie-veineuse","Thrombo-embolie veineuse","fr",1776087000,[],[1424,1425],{"name":347,"id":358,"uuid":353,"slug":359,"url":360,"full_slug":360},{"name":1386,"id":1387,"uuid":1382,"slug":9,"url":1384,"full_slug":1384},[1427,1434,1440],{"id":1391,"alt":16,"content_length":1428,"content_type":1429,"copyright":16,"created_at":1430,"deleted_at":53,"focus":16,"is_private":277,"title":16,"updated_at":1431,"s3_filename":1432,"meta_data":1433},282950,"image/webp","2025-12-09T17:42:47.391Z","2025-12-09T17:42:48.158Z","f/850807391887861/2068x1484/1aea4e8fb2/senior-woman-holding-doctors-hand.webp",{},{"id":287,"alt":16,"content_length":1435,"content_type":1429,"copyright":16,"created_at":1436,"deleted_at":53,"focus":16,"is_private":277,"title":16,"updated_at":1437,"s3_filename":1438,"meta_data":1439},41946,"2025-12-09T17:45:32.386Z","2025-12-09T17:45:33.077Z","f/850807391887861/2216x1568/ea857fcb8e/shapes.webp",{"alt":16,"title":16,"source":16,"copyright":16},{"id":923,"alt":16,"content_length":1441,"content_type":1442,"copyright":16,"created_at":1443,"deleted_at":53,"focus":16,"is_private":277,"title":16,"updated_at":1444,"s3_filename":1445,"meta_data":1446},28051,"image/png","2025-12-04T18:40:03.538Z","2025-12-04T18:40:04.613Z","f/850807391887861/600x600/c301964117/checkmark-icon.png",{},1776087480541]