Reducing Venous Thrombosis Embolism (VTE) in Patients 12 and Older

Published on Apr 05, 2019 in CHOP News

Why is this important?

Hospital acquired blood clots, known as venous thromboembolism (VTE) can cause harm in hospitalized pediatric patients. These include pain at the site of blood clot (thrombosis), loss of vein access, pulmonary embolism, or infection. Guidelines from the national organization Solutions for Patient Safety recommend a VTE prevention bundle: routine VTE risk screening for all patients aged 12 years or older and risk-based prevention interventions.

What we did

VTE prevention is part of Children’s Hospital of Philadelphia (CHOP) Harm Prevention Program. A multidisciplinary committee created a VTE prevention clinical pathway. In addition, existing VTE prevention processes in the electronic health record (EHR) were improved based on feedback from the nursing and frontline clinicians.

Summary of results

The team was able to reduce the rate of VTE in children cared for at CHOP by 50 percent since 2015. The rate in fiscal year 2015 was 0.04 per 1,000 patient days, and the rate in fiscal year 2018 was 0.02. In addition, since implementation of the pathway, there have been 17 months with no associated VTEs. Furthermore, the VTE bundle has been embedded into daily practice as demonstrated by significant improvement in bundle adherence from 25 percent in February 2017 to more than 90 percent since May 2018.