VTE Prevention in Medical and Surgical Patients
Steps for improving the prevention of VTE for medical/surgical hospitalized patients:
- Is the patient at increased risk for VTE (i.e. is thromboprophylaxis indicated)?
- Is anticoagulant thromboprophylaxis contraindicated?
- Provide appropriate thromboprophylaxis (anticoagulant or, if anticoagulant contraindicated, mechanical).
- Reassess if significant change in patient status and at transitions of care.
Safer Healthcare Now!
VTE Getting Started Kit (Safer Healthcare Now!, 2012) includes Appendix Q: VTE Pocket Card with detailed information relative to the four steps for improving the prevention of VTE and additional information related to recommended doses of anticoagulant prophylaxis.
VTE Prevention in Obstetrical Patients
It is generally agreed that universal postpartum thromboprophylaxis is neither cost-effective nor recommended. In weighing the risks of treatment, it is recommended to use an absolute VTE risk of greater than one per cent in considering thromboprophylaxis during pregnancy and postpartum (Chan et al., 2014). For specific recommendations for VTE thromboprophylaxis in obstetrical patients refer to the Society of Obstetricians and Gynaecologists of Canada (SOGC) 2014 Clinical Practice Guidelines (Chan et al, 2014).
- Individual risk assessment for venous thromboembolism should be performed prior to all pregnancies, once pregnancy is achieved, and repeated throughout pregnancy as new clinical situations arise (SOGC, 2014).
- Women at increased risk should be advised of the symptoms and signs of venous thromboembolism (SOGC, 2014).
- Good hydration and mobilization should be encouraged for every woman postpartum (SOGC, 2014).