Prescriber knowledge and attitudes regarding non-administration of prescribed pharmacologic venous thromboembolism prophylaxis

Kara L Piechowski; Stacy Elder; Leigh E Efird; Elliott R Haut; Michael B Streiff; Brandyn D Lau; Peggy S Kraus; Cynthia S Rand; Victor O Popoola; Deborah B Hobson; Norma E Farrow; Dauryne Shaffer; Kenneth M Shermock

doi:10.1007/s11239-016-1378-8

Prescriber knowledge and attitudes regarding non-administration of prescribed pharmacologic venous thromboembolism prophylaxis

J Thromb Thrombolysis. 2016 Nov;42(4):463-70. doi: 10.1007/s11239-016-1378-8.

Authors

Kara L Piechowski¹, Stacy Elder², Leigh E Efird², Elliott R Haut^{3

4

5

6}, Michael B Streiff^{4

7}, Brandyn D Lau^{3

8}, Peggy S Kraus², Cynthia S Rand⁹, Victor O Popoola³, Deborah B Hobson^{4

10}, Norma E Farrow⁴, Dauryne Shaffer^{4

10}, Kenneth M Shermock^{2

4

11}

Affiliations

¹ Department of Pharmacy, Johns Hopkins Hospital, 600 North Wolfe Street, Baltimore, MD, 21287, USA. kpiechowski1@gmail.com.
² Department of Pharmacy, Johns Hopkins Hospital, 600 North Wolfe Street, Baltimore, MD, 21287, USA.
³ Division of Acute Care Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
⁴ Armstrong Institute for Patient Safety and Quality, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
⁵ Division of Anesthesiology/Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
⁶ Division of Health Policy and Management, Johns Hopkins University School of Public Health, Baltimore, MD, USA.
⁷ Division of Hematology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
⁸ Division of Health Sciences Informatics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
⁹ Pulmonary and Critical Care Medicine Department, Johns Hopkins University, Baltimore, MD, USA.
¹⁰ Department of Nursing, Johns Hopkins Hospital, Baltimore, MD, USA.
¹¹ Center for Drug Safety and Effectiveness, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.

PMID: 27209202
DOI: 10.1007/s11239-016-1378-8

Abstract

Pharmacologic venous thromboembolism (VTE) prophylaxis is important patient safety practice in hospitalized patients. However, a substantial number of ordered doses are not administered. Patient and nursing attitudes and behaviors can influence whether a patient receives a dose. The objective of this single center study was to evaluate prescriber knowledge and attitudes regarding missed doses of pharmacologic VTE prophylaxis. An anonymous, 9-question survey was administered to internal medicine and general surgery resident physicians. The survey captured prescriber opinions on issues related to non-administration of VTE prophylaxis. Thirty-two percent of medicine residents compared with 3 % of surgery residents felt pharmacologic VTE prophylaxis was not necessary in an independently ambulating patient (P < 0.001). Medicine residents were more likely to agree that it is appropriate for nurses to make clinical decisions to determine whether a dose of pharmacologic VTE prophylaxis should be administered to a patient (24 vs. 0 %, P < 0.001). Study findings indicate the need for additional resident physician education. Further investigation is needed to assess these beliefs and ensure patients receive necessary VTE prophylaxis.

Keywords: Patient safety; Survey; Thromboembolism; VTE prophylaxis.

Publication types

Clinical Trial

MeSH terms

Drug Prescriptions*
Female
Humans
Internship and Residency*
Knowledge*
Male
Venous Thromboembolism / prevention & control*