151 - Prevention of VTE in Inpatient Rehabilitation Facility : A Quality Improvement Project

Objectives: It was noted that for our inpatient rehabilitation facility, our overall rate of hospital-acquired venous thromboembolism (VTE) was 0.61, which is higher than the benchmark 0.39 in the Exchange of Quality Data for Rehabilitation (EQUADR). Therefore, the objective of our quality improvement project was early identification and intervention of patients at risk for venous thromboembolism to reduce the incidence to be lower than the EQUADR benchmark.

Design: Patients who developed a VTE in our rehabilitation facility during a six-month time frame were analyzed. A pattern was found where most of these patients were not placed on DVT prophylaxis even though they qualified as a high risk for VTE with the Padua prediction score. Therefore, we updated our admission order set where a patient's risk level for VTE must be assessed by the Padua prediction score, and if the patient was a high risk for VTE, they must be placed on DVT prophylaxis. If it was unknown if the patient had a contraindication for anticoagulation, an option on the order set could be chosen where AC was placed on hold so that the physician could further investigate but then a "Best Practice Alert" (BPA) would pop up every time they sign into the patient's chart until either DVT prophylaxis was initiated or documentation to contraindication was done.

Results: VTE in our rehab facility dramatically decreased by 84%.

Conclusions: Most patients in the acute rehabilitation facility are a high risk for developing a venous thromboembolism and therefore, should be placed on DVT prophylaxis if not contraindicated.