What do Boston Red Sox Manager Terry Francona, NBC journalist David Bloom, and professional wrestler Jesse Ventura all have in common? They've all suffered from a deep vein thrombosis (DVT).
According to the Coalition to Prevent DVT Web site, 2 million Americans suffer from DVT every year. About 300,000 patients die from a fatal pulmonary embolism (PE), most of which are caused by DVT. That's more than the number of deaths caused by breast cancer and AIDS combined. The reality is that DVT-related PE is the most common cause of preventable death in the hospital. But that's not all. Only about one-third of the "at risk" hospitalized patients receive venous thromboembolism (VTE, the umbrella term for DVT and PE) prophylaxis. PE is the leading cause of maternal death associated with childbirth. A woman's risk of developing VTE is six times greater when she's pregnant. And in older adults, DVT has a 21% 1-year mortality rate, and PE has a 39% 1-year mortality rate. So what are we doing about it?
Both The Joint Commission and the Centers for Medicare and Medicaid Services (CMS) tell us that we must assess all patients for VTE risk, and must administer prophylaxis to at-risk patients to prevent DVT. If we don't meet these expectations and our patients develop a DVT or PE, we risk losing reimbursement for the cost of treating that event.
Acting U.S. Surgeon General Steven K. Galson, MD, MPH, also understands the importance of this issue. Last September he issued a Call to Action to Prevent DVT/PE, significantly raising the awareness of this serious and potentially fatal condition. In this call to action, Dr. Galson stated that "Every hospital should develop a formal plan that addresses DVT prophylaxis."
The call to action urges a coordinated effort to:
* increase awareness about VTE
* implement evidence-based practices for DVT
* conduct more research on the causes, prevention, and treatment of DVT.
You're likely to agree that many forces drive our DVT/PE practice. But truly, we should be the ones who drive our practice. We should assess for risk, get orders to administer prophylaxis when appropriate, and teach VTE awareness each and every day because it's the right thing to do for our patients, not because someone tells us to do it. Because it's the right thing to do for our patients should always be the most influential force that drives our practice. Our job is to be our patients' advocate 100% of the time. Take this opportunity, DVT Awareness Month, to evaluate how you can enhance your practice and improve the outcomes of your patients at risk.
Until the next time: Be healthy, be happy, and be great advocates for your patients!!
AnneMarie Palatnik
Coordinator of Continuing Education, Clinical Education & Research, Virtua Health, Marlton, N.J., [email protected]
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