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Patterns in VTE Prophylaxis Dose Delays Among Hospitalized Patients
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A6833 - Patterns in VTE Prophylaxis Dose Delays Among Hospitalized Patients
Author Block: S. Karanth1, S. Patil1, M. Ayad1, A. Sen1, K. Gopal1, K. Gomez2, B. Patel1; 1Internal Medicine, The University of Texas Health Science Center, Houston, TX, United States, 2Memorial Hermann Health System, Houston, TX, United States.
Objective: To see whether the time of the day and day of the week of scheduled VTE prophylactic dose is associated with incidence of delayed dose.
Rationale: Venous thromboembolism (VTE) is commonly seen in hospitalized patients. There is strong evidence that providing appropriate prophylaxis can reduce the risk of VTE in them. Yet, prophylaxis is sometimes missed or delayed affecting the overall quality of care. In our study we have found out that the number of times VTE prophylaxis was delayed by more than 1-hour and 2-hours were associated with increased risk of VTE. Although the importance of VTE-prophylaxis is well studied, it was important to see if there are any patterns of delayed doses with regards to time of the day and day of the week.
Methods: A total of 18,830 patients admitted to 1000 bed Level-1 Trauma Center, who received pharmacological VTE prophylaxis from April-2014 to February-2016 were included in our study based on guidelines. Time stamps from electronic health records were analyzed and the duration was calculated as the number of minutes from time of schedule to time of administration. Any delay of more than 6 hours were considered a probable missed dose and were excluded from the analysis. The data was analyzed to look at the patterns of delayed doses with regards to the time of the day and day of the week.
Results: A total of 112 patients developed VTE and the VTE incidence rate was 6 per 1,000. Median time to VTE-prophylaxis dose administration was 41 mins (range 0mins-348mins) and 43 mins (range 0mins-359mins) among patients with and without VTE respectively. Most doses were delayed around 4 PM and 8 AM. There were 36,861 instances of at least 1-hour delay in dose administration, of which 32.23% (11,882 instances) were at 4 PM and 30.04% (11,072 instances) were at 8 AM. Similarly there were 7,168 instances of at least 2-hour delay in dose administration, of which 28.38% (2,034 instances) were at 4 PM and 29.14% (2,089 instances) were at 8 AM. There was no pattern in the day of the week.
Conclusion: VTE prophylaxis dose delays were mostly seen around 4 PM and 8 AM. The average number of prophylaxis dose delays was significantly higher among patients with VTE as compared to patients without VTE. In addition to addressing missed prophylactic doses, hospital VTE prevention strategies must also focus on prophylactic dose delays.
Author Block: S. Karanth1, S. Patil1, M. Ayad1, A. Sen1, K. Gopal1, K. Gomez2, B. Patel1; 1Internal Medicine, The University of Texas Health Science Center, Houston, TX, United States, 2Memorial Hermann Health System, Houston, TX, United States.
Objective: To see whether the time of the day and day of the week of scheduled VTE prophylactic dose is associated with incidence of delayed dose.
Rationale: Venous thromboembolism (VTE) is commonly seen in hospitalized patients. There is strong evidence that providing appropriate prophylaxis can reduce the risk of VTE in them. Yet, prophylaxis is sometimes missed or delayed affecting the overall quality of care. In our study we have found out that the number of times VTE prophylaxis was delayed by more than 1-hour and 2-hours were associated with increased risk of VTE. Although the importance of VTE-prophylaxis is well studied, it was important to see if there are any patterns of delayed doses with regards to time of the day and day of the week.
Methods: A total of 18,830 patients admitted to 1000 bed Level-1 Trauma Center, who received pharmacological VTE prophylaxis from April-2014 to February-2016 were included in our study based on guidelines. Time stamps from electronic health records were analyzed and the duration was calculated as the number of minutes from time of schedule to time of administration. Any delay of more than 6 hours were considered a probable missed dose and were excluded from the analysis. The data was analyzed to look at the patterns of delayed doses with regards to the time of the day and day of the week.
Results: A total of 112 patients developed VTE and the VTE incidence rate was 6 per 1,000. Median time to VTE-prophylaxis dose administration was 41 mins (range 0mins-348mins) and 43 mins (range 0mins-359mins) among patients with and without VTE respectively. Most doses were delayed around 4 PM and 8 AM. There were 36,861 instances of at least 1-hour delay in dose administration, of which 32.23% (11,882 instances) were at 4 PM and 30.04% (11,072 instances) were at 8 AM. Similarly there were 7,168 instances of at least 2-hour delay in dose administration, of which 28.38% (2,034 instances) were at 4 PM and 29.14% (2,089 instances) were at 8 AM. There was no pattern in the day of the week.
Conclusion: VTE prophylaxis dose delays were mostly seen around 4 PM and 8 AM. The average number of prophylaxis dose delays was significantly higher among patients with VTE as compared to patients without VTE. In addition to addressing missed prophylactic doses, hospital VTE prevention strategies must also focus on prophylactic dose delays.
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