| Autor: |
Melissa H, Lippitt, Emily S, Johnson, Anja S, Frost, Sharon D, Thompson, Payam K, Kashi, Anna L, Beavis, Amanda N, Fader, J Stuart, Ferriss, Rebecca L, Stone, Stephanie L, Wethington |
| Rok vydání: |
2022 |
| Předmět: |
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| Zdroj: |
Journal of the American College of Surgeons. 235:306-314 |
| ISSN: |
1072-7515 |
| DOI: |
10.1097/xcs.0000000000000253 |
| Popis: |
Perioperative venous thromboembolism (VTE) is a significant cause of morbidity and mortality after gynecologic cancer surgery. Here we report a quality improvement intervention to increase perioperative VTE chemoprophylaxis compliance.All operations performed by a gynecologic oncologist at a tertiary urban university medical center admitted to the hospital for at least one midnight were included. Using a pre/post design with a washout period, we sought to increase perioperative VTE chemoprophylaxis compliance from 22% in the historical control (HC) cohort to 90% in the quality improvement (QI) cohort. The perioperative VTE chemoprophylaxis process was standardized by addressing four domains: preoperative VTE chemoprophylaxis, surgical time-out, postoperative VTE chemoprophylaxis, and intervention education and compliance tracking. Pearson's chi-square test was used to compare HC vs QI cohort compliance.There were 130 surgical cases in the HC cohort and 131 in the QI cohort. Forty-two percent underwent laparotomy, and 57% had cancer at the time of operation. VTE chemoprophylaxis compliance improved from 22% in the HC cohort to 82% in the QI cohort (p0.001). Preoperative VTE chemoprophylaxis compliance improved from 76% in the HC cohort to 94% in the QI cohort (p0.001), and postoperative VTE chemoprophylaxis compliance improved from 27% to 87% (p0.001). Thirty-day postoperative VTE occurred in three patients (2%) in the HC cohort and none in the QI cohort (p = 0.08).A low-cost and low-technology QI initiative intervention improved perioperative compliance with VTE chemoprophylaxis. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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