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www.ahrq.gov/research/findings/making-healthcare-safer/mhs3/practices.html
April 01, 2020 - Carbapenem-Resistant Enterobacteriaceae ( PDF , 1.4 MB)
Contact Precautions
Harms Due to Anticoagulants … Intervention
TCM: Transitional Care Model
Venous Thromboembolism ( PDF , 1.4 MB)
Postsurgical Prophylaxis
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www.ahrq.gov/patient-safety/about/uni-chicago-medicine.html
February 01, 2024 - The aims of the taskforce were to strengthen established chemical and mechanical prophylaxis and ambulation … concluded that the aims of the taskforce would be to strengthen established chemical and mechanical prophylaxis
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www.ahrq.gov/hai/tools/surgery/tools/applying-cusp/or-briefing-audit.html
December 01, 2017 -
Airway risk
Access issues
Bleeding concerns (e.g., anticoagulant …
Allergies
Glycemic control
Deep vein thrombosis prophylaxis
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www.ahrq.gov/hai/tools/surgery/modules/implementation/audit-briefing-slides.html
December 01, 2017 - Bleeding concerns (e.g., anticoagulant use).
Blood availability.
Allergies. … Deep vein thrombosis prophylaxis.
Warmers.
Lab/radiology review. … Deep vein thrombosis (DVT) prophylaxis - 100% Yes.
Glycemic control - 40% Yes. … Anticoagulant use - 10% Yes.
Access issues - 20% Yes.
Airway risk - 20% Yes.
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/qitoolkit/combined/d4i_combo_psi12-dvt-bestpractices.pdf
May 20, 2016 - Selection
Appropriate use of prophylaxis for VTE in patients
at risk is the number one strategy … o Focus on reaching VTE prophylaxis targets and reporting to key medical staff
committees. … o Draft or adopt evidence-based protocols that standardize VTE risk assessment and
prophylaxis.6 … Selection
• Prompt providers to order VTE prophylaxis when completing admission or transfer orders … .3
• Determine contraindications to pharmacologic prophylaxis and deliver decision support to
the
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www.ahrq.gov/hai/tools/ambulatory-surgery/sections/implementation/implementation-guide/app-d.html
April 01, 2017 - Warmer in place
|___| Risk of venous thromboembolism
- Compression boots and/or anticoagulants … Surgical procedure to be performed matches the consent
|___| Surgical site
|___| Has antibiotic prophylaxis
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/ambulatory-surgery/sections/implementation/training-tools/asc-checklist-template.docx
January 01, 2009 - operation longer than 1 hour
· Warmer in place
· Risk of venous thromboembolism
· Compression boots and/or anticoagulants … s name
· Surgical procedure to be performed matches the consent
· Surgical site
· Has antibiotic prophylaxis
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www.ahrq.gov/patient-safety/settings/hospital/vtguide/guideref.html
July 01, 2018 - Venous thromboembolism risk and prophylaxis in hospitalised medically ill patients. … Situational awareness improves prevalence of VTE Prophylaxis on multiple nursing units. … Venous thromboembolism risk and prophylaxis in hospitalised medically ill patients. … Medication chart intervention improves inpatient thromboembolism prophylaxis. … Venous thromboembolism prophylaxis and risk assessment in medical patients.
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www.ahrq.gov/patient-safety/settings/hospital/vtguide/guide1.html
February 01, 2016 - Relying on order sets alone will not reach desired levels of appropriate VTE prophylaxis. … The most effective improvement strategies focus on improving ordered prophylaxis, monitoring for care … materials around the subset of patients who may require extended duration prophylaxis. … Key metrics include the prevalence of appropriate VTE prophylaxis and the incidence of HA-VTE. … Even the best order set, however, will fail to achieve near-perfect appropriate prophylaxis.
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psnet.ahrq.gov/web-mm/cognitive-and-communication-blind-spot-contributes-permanent-paralysis
January 13, 2010 - their response to unfractionated heparin—with some patients requiring large doses to achieve adequate prophylaxis … or activated factor X levels, has been proposed as a means to monitor the effectiveness of heparin prophylaxis … injured patients, ordering clinicians must carefully weigh the risks and benefits of pharmacologic prophylaxis … Early pharmacological venous thromboembolism prophylaxis is safe after operative fixation of traumatic
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www.uspreventiveservicestaskforce.org/uspstf/recommendation/aspirin-prophylaxis-myocardial-infarction-preventive-medication-1996
January 01, 1996 - adults
There is insufficient evidence to determine whether the proven benefits of routine aspirin prophylaxis … The association between aspirin prophylaxis and reduction in first MI was accentuated in women who currently … The success of aspirin prophylaxis in persons who have documented disease (secondary prevention) is felt … At the present time, data are insufficient to support or oppose the use of aspirin prophylaxis for the … The Salt Collaborative Group Swedish aspirin low-dose trial (SALT) of 75 mg aspirin as secondary prophylaxis
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www.ahrq.gov/sites/default/files/2024-10/barnes-report.pdf
January 01, 2024 - For
more than five decades, warfarin was the only available oral anticoagulant. … 3337 (66%) were possible critical,
and 1033 (21%) were for-your-information alerts for potential VTE prophylaxis … Inappropriate Prescription of Direct Oral Anticoagulant Starter
Packs. … Evaluation of Dose-Reduced
Direct Oral Anticoagulant Therapy. Am J Med 2016;129:1198-204.
3. … Renal function in atrial fibrillation patients switched from warfarin to
a direct oral anticoagulant
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psnet.ahrq.gov/web-mm/copy-and-paste
December 10, 2014 - note also stated that the patient would receive subcutaneous heparin for venous thromboembolism (VTE) prophylaxis … resident and attending, and the patient was ultimately discharged having never received the intended VTE prophylaxis—despite … medication record from the previous hospitalization, was it realized that the patient never received any VTE prophylaxis … medicine: the use of clinical decision support to remind the physician to carry out things like VTE prophylaxis … Related Resources
WebM&M Cases
Direct Oral Anticoagulants
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psnet.ahrq.gov/issue/evaluating-mobile-application-improving-clinical-laboratory-test-ordering-and-diagnosis
August 07, 2019 - April 20, 2016
Improved prophylaxis and decreased rates of preventable harm with the … use of a mandatory computerized clinical decision support tool for prophylaxis for venous thromboembolism
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digital.ahrq.gov/ahrq-funded-projects/evaluation-scaled-scaling-acceptable-cds-approach-implementation-interoperable-cds-venous
January 01, 2024 - researchers plan to scale and evaluate the implementation of a CDS tool for venous thromboembolism (VTE) prophylaxis … The researchers plan to widely disseminate this new VTE prophylaxis in TBI tool with U.S. trauma societies … , hybrid type II trial of interoperable clinical decision support to improve venous thromboembolism prophylaxis … , hybrid type II trial of interoperable clinical decision support to improve venous thromboembolism prophylaxis … The researchers plan to widely disseminate this new VTE prophylaxis CDS tool for TBI patients to U.S.
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www.ahrq.gov/patient-safety/resources/learning-lab/building-ambulatory-long-desc.html
April 01, 2021 - Pneumocystis jirovecii pneumonia (PJP) prophylaxis patterns among patients with rheumatic diseases receiving … Using health-system-wide data to understand hepatitis B virus prophylaxis and reactivation outcomes in
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psnet.ahrq.gov/web-mm/signout-fallout
November 16, 2022 - 4, the ICU team and the neurosurgeon decided it would be safe to start deep venous thrombosis (DVT) prophylaxis … collectively decided that, if the CT scan that day remained unchanged, the benefits of low-dose DVT prophylaxis … full-dose anticoagulation (rather than lower dose anticoagulation, appropriate for venous thromboembolism prophylaxis
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psnet.ahrq.gov/innovation/johns-hopkins-venous-thromboembolism-vte-collaborative-studies-and-implements-methods
June 19, 2024 - to patients and how to administer VTE prophylaxis. … Understand barriers to VTE prophylaxis at the institution. … clinical decision support tool for prophylaxis for venous thromboembolism in trauma. … Venous Thromboembolism Prophylaxis (eCQM). Accessed March 14, 2022. … clinical decision support tool for prophylaxis for venous thromboembolism in trauma.
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/qitoolkit/combined/standalone_psi_casestudy.pdf
April 02, 2025 - improve DVT/PE prevention, including:
• Providing additional education and resources on existing prophylaxis … site;
• Assisting clinical pharmacists in daily identification of all patients not receiving chemical
prophylaxis … ; and
• Shifting chemical prophylaxis dosing to avoid missed doses due to changes in scheduled
surgical … investigation is whether the DVT was preventable (for example, whether
the patient was given the right prophylaxis
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www.ahrq.gov/sites/default/files/wysiwyg/hai/tools/mrsa/115-daily-goals-icu-checklist.docx
October 01, 2024 - Diet: Advance as tolerated
· Nothing by mouth (NPO)
· Bowel regimen Yes No
Insert text
Prophylaxis … bed (HOB) greater than 30 degrees _____
Oral care _____
Insert text
DISPOSITION CONTINUED
Prophylaxis