practice partner
Patient Safety
We use this forum to regularly report on findings from patient safety organizations, expert review
committees of the Office of the Chief Coroner, and inquests.
Discontinuing
non-surgical
VTE prophylaxis
post-discharge
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P
pre-printed physician orders and pharmacist
hysicians are encouraged to fasupport to physicians, have ensured that 80
miliarize themselves with current
to 90% of acutely ill hospital patients with
guidelines with respect to the use
indications for VTE prophylaxis are now
of venous thromboembolic (VTE)
receiving it.
prophylaxis outside of the acute care setThe Committee recently reviewed the
ting, says the Geriatric and Long-Term Care
circumstances surrounding two deaths after
Review Committee.
concerns were identified regarding the use of
“Health-care professionals need to ensure
prophylactic anticoagulation
that anticoagulation is disconin elderly persons at risk of
tinued when appropriate and
falling.
that dosing is correct, based
Patient A was an 88-yearon individual patient factors,” “Thromboprophylaxis
old female with progressive
stated the Committee, which
was not however,
cognitive and physical decline
reports to the Office of the
indicated
beyond
the
over several months following
Chief Coroner.
“Great strides have been
acute hospital stay” a hospitalization and intensive
care unit stay for a seizure
made over the past several
disorder.
years to increase compliance
Over the next several
with VTE prophylaxis in
months, she had two acute hospitalizations
those patients where it is indicated,” states the
related to urinary tract infections and deCommittee report.
lirium. During these acute care stays, she
The American College of Chest Physicians’
was appropriately treated with enoxaparin
CHEST guidelines (Chest. 2012;141(2_
for prevention of venous thromboembolism.
suppl):1S. doi:10.1378/chest.1412S1) are
Once medically stable, she was found to be
broadly circulated and are frequently updated.
no longer able to manage at home and was
The guidelines, which provide standardized,
Issue 4, 2015 Dialogue
Issue4_15.indd 51
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2015-12-16 9:36 AM