EBP
1
Evidence Based Practice Proposal-Final Paper
Evidence Based Practice Project
December 23, 2020
Rita Shrestha
Grand Canyon University
, 2
Abstract
Venous Thromboembolism (VTE) can occur after major general surgery. It is one of the common
cause of death in hospitalized patients in United States. There is higher risk of deep venous
thrombosis (DVT) and pulmonary embolism (PE) in the patient with cardio- vascular surgery.
VTE prevention is considered as a patient- safety measure in quality initiatives. In healthcare the
current culture is focused on patient safety and providing quality health care. Culture safety only
cannot create change within an organization. Venous thromboembolism (VTE) requires
coordination of care across from multidisciplinary team supported by a system that assists in the
process of delivering and tracking the care outcomes. In this paper, I have describe the measures
of VTE prevention which include mechanical methods and pharmacologic methods. I have
describe the use of the evidence- based, intervention, implementation, system support, VTE
Safety Toolkit assessment. Patients undergoing surgery should be manage according to the VTE
risk based on risk factors related disease and procedure.
Keywords: venous thromboembolism, deep venous thrombosis, pulmonary embolism,
prevention, mechanical methods, pharmacologic methods, risk stratification
, 3
Section A: Organizational Culture and Readiness Assessment
Venous Thromboembolism (VTE) is a common and potentially life threatening condition. Deep
vein thrombosis (DVT) and pulmonary embolism (PE) are the blood clots formed. Common site
of thrombosis occur is in deep veins, which is specified risk factors and found in over 80 percent
of VTE patients. These are severe form of complications which are associated with high
morbidity and mortality. This also increase the length of stay in hospital and make costly as well
as causes of readmission. The high risk of VTE are among the general surgeries, orthopedic,
cardiovascular and abdominal surgeries. Preventing DVT and PE after the surgery is most
important. DVT/VTE prophylaxis is recommend according to the international guidelines after
immediate postoperative period after general, orthopedic and cardio thoracic surgery. The
prophylaxis include pharmacology and mechanical intervention (Sutzko, 2018). The necessitates
organizational readiness and cultural changes focused on resolving this problem. In my
organization, there is a flow sheet tab in EPIC to chart under the patient daily assessment for
head to toes assessment where nurses have to chart which VTE/DVT prophylaxis is on patient,
whether it's applied or not if not the reason need to document and notification to provider is
necessary. The protocol have been place in high standards for patient safety. There are the VTE
collaborative those who monitor on these orders. However, an implementation barrier exists
following lack of policies reinforcing these protocols. Due to lack of acceptance of standardized
protocols, policy awareness and time pressure it causes barrier in implementation.
1
Evidence Based Practice Proposal-Final Paper
Evidence Based Practice Project
December 23, 2020
Rita Shrestha
Grand Canyon University
, 2
Abstract
Venous Thromboembolism (VTE) can occur after major general surgery. It is one of the common
cause of death in hospitalized patients in United States. There is higher risk of deep venous
thrombosis (DVT) and pulmonary embolism (PE) in the patient with cardio- vascular surgery.
VTE prevention is considered as a patient- safety measure in quality initiatives. In healthcare the
current culture is focused on patient safety and providing quality health care. Culture safety only
cannot create change within an organization. Venous thromboembolism (VTE) requires
coordination of care across from multidisciplinary team supported by a system that assists in the
process of delivering and tracking the care outcomes. In this paper, I have describe the measures
of VTE prevention which include mechanical methods and pharmacologic methods. I have
describe the use of the evidence- based, intervention, implementation, system support, VTE
Safety Toolkit assessment. Patients undergoing surgery should be manage according to the VTE
risk based on risk factors related disease and procedure.
Keywords: venous thromboembolism, deep venous thrombosis, pulmonary embolism,
prevention, mechanical methods, pharmacologic methods, risk stratification
, 3
Section A: Organizational Culture and Readiness Assessment
Venous Thromboembolism (VTE) is a common and potentially life threatening condition. Deep
vein thrombosis (DVT) and pulmonary embolism (PE) are the blood clots formed. Common site
of thrombosis occur is in deep veins, which is specified risk factors and found in over 80 percent
of VTE patients. These are severe form of complications which are associated with high
morbidity and mortality. This also increase the length of stay in hospital and make costly as well
as causes of readmission. The high risk of VTE are among the general surgeries, orthopedic,
cardiovascular and abdominal surgeries. Preventing DVT and PE after the surgery is most
important. DVT/VTE prophylaxis is recommend according to the international guidelines after
immediate postoperative period after general, orthopedic and cardio thoracic surgery. The
prophylaxis include pharmacology and mechanical intervention (Sutzko, 2018). The necessitates
organizational readiness and cultural changes focused on resolving this problem. In my
organization, there is a flow sheet tab in EPIC to chart under the patient daily assessment for
head to toes assessment where nurses have to chart which VTE/DVT prophylaxis is on patient,
whether it's applied or not if not the reason need to document and notification to provider is
necessary. The protocol have been place in high standards for patient safety. There are the VTE
collaborative those who monitor on these orders. However, an implementation barrier exists
following lack of policies reinforcing these protocols. Due to lack of acceptance of standardized
protocols, policy awareness and time pressure it causes barrier in implementation.
