Optimal Prevention of Hospital Acquired Venous Thromboe*

医院获得性静脉血栓的最佳预防*

• 批准号: 7010133
• 负责人: GREG MAYNARD
• 金额: $ 18.43万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-09-01 至 2007-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7010133
• 关键词: clinical research; computer program /software; cooperative study; disease /disorder prevention /control; disease /disorder proneness /risk; health care model; health care service evaluation; health services research tag; hospital patient care; hospitals; human subject; information dissemination; medical complication; model design /development; patient care planning; patient oriented research

DESCRIPTION (provided by the applicant): Hospital-acquired venous thromboembolism (VTE) is a significant source of morbidity and mortality in hospitalized patients. Improved adherence to proven prophylactic methods should substantially reduce this threat to the safety of hospitalized patients. Our long-term objective is to eliminate preventable hospital acquired VTE in our "model hospital," and assist other institutions to achieve the same objective. Our intervention will maximize the use of appropriate VTE prophylaxis, and minimize VTE risk factors whenever feasible. Specifically, we will: 1) Implement a VTE prophylaxis protocol and a specialized order set which will mandate a clinician assessment of VTE risk level for every patient, and will provide a menu of recommended VTE prophylaxis options for each level of VTE risk. The protocol will mandate this risk-assessment, at a minimum, at the time of admission, and any transfer during the hospitalization. We will enhance the successful implementation of our VTE prophylaxis model with a tiered resource team, using the Institute for Healthcare Improvement model for improvement. We will track the resulting increase in prevalence of appropriate VTE prophylaxis, and the decrease in incidence of hospital-acquired VTE. 2) Create a modifiable toolkit that can be disseminated to health care systems caring for patients at risk of VTE, which will facilitate successful interventions similar to those validated in the "model hospital." The toolkit will follow the Model for Improvement recommended by the Institute for Healthcare Improvement (IHI) in order to guide the formation and operation of multidisciplinary teams within healthcare systems. The toolkit will also include software-based protocols which the teams can use to create and modify VTE prophylaxis order sets based on their own evidence-based conclusions. Relevance: 250,000 patients in United States hospitals require anticoagulation for deep vein thromboses and pulmonary emboli every year, and half of these develop in the hospital. Proven prophylactic regimens which are safe and cost-effective are available, but are routinely underutilized. This project will establish optimal prevention of hospital-acquired VTE, and will produce a toolkit that will allow other institutions do the same, thereby substantially reducing the morbidity, mortality, and cost associated with this problem.

描述（由申请方提供）：医院获得性静脉血栓栓塞（VTE）是住院患者发病率和死亡率的重要来源。改善对已证实的预防方法的依从性应能大大减少对住院患者安全的这种威胁。我们的长期目标是在我们的“示范医院”中消除可预防的医院获得性静脉血栓栓塞，并协助其他机构实现同样的目标。我们的干预措施将最大限度地使用适当的静脉血栓栓塞预防，并尽量减少静脉血栓栓塞的危险因素。具体而言，我们将：1）实施VTE预防方案和专门的医嘱集，该医嘱集将要求临床医生评估每位患者的VTE风险水平，并将为每种VTE风险水平提供推荐的VTE预防选项菜单。该方案将至少在入院时以及住院期间的任何转移时强制进行该风险评估。我们将利用医疗保健改进研究所的改进模型，通过分层资源团队，加强我们的静脉血栓栓塞预防模型的成功实施。我们将跟踪适当的静脉血栓栓塞预防的流行率增加，以及医院获得性静脉血栓栓塞的发病率下降。 2)创建一个可修改的工具包，可以分发给照顾有VTE风险的患者的卫生保健系统，这将有助于类似于在“示范医院”中验证的成功干预措施。“该工具包将遵循医疗保健改进研究所（IHI）建议的改进模式，以指导医疗保健系统内多学科团队的组建和运作。该工具包还将包括基于软件的协议，团队可以根据自己的循证结论创建和修改VTE预防顺序集。相关性：美国医院每年有250，000名患者需要抗凝治疗深静脉血栓和肺栓塞，其中一半是在医院发生的。安全和具有成本效益的预防性治疗方案是可用的，但通常未得到充分利用。该项目将建立医院获得性静脉血栓栓塞的最佳预防措施，并将制作一个工具包，使其他机构也能这样做，从而大大降低发病率、死亡率和与此问题相关的费用。