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Prescriber knowledge and attitudes regarding non-administration of prescribed pharmacologic venous thromboembolism prophylaxis |
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| Authors: | Kara L. Piechowski Stacy Elder Leigh E. Efird Elliott R. Haut Brandyn D. Lau Peggy S. Kraus Cynthia S. Rand Victor O. Popoola Deborah B. Hobson Norma E. Farrow Dauryne Shaffer Kenneth M. Shermock |
| Affiliation: | 1.Department of Pharmacy,Johns Hopkins Hospital,Baltimore,USA;2.Division of Acute Care Surgery, Department of Surgery,Johns Hopkins University School of Medicine,Baltimore,USA;3.Armstrong Institute for Patient Safety and Quality,Johns Hopkins University School of Medicine,Baltimore,USA;4.Division of Anesthesiology/Critical Care Medicine,Johns Hopkins University School of Medicine,Baltimore,USA;5.Division of Health Policy and Management,Johns Hopkins University School of Public Health,Baltimore,USA;6.Division of Hematology, Department of Medicine,Johns Hopkins University School of Medicine,Baltimore,USA;7.Division of Health Sciences Informatics,Johns Hopkins University School of Medicine,Baltimore,USA;8.Pulmonary and Critical Care Medicine Department,Johns Hopkins University,Baltimore,USA;9.Department of Nursing,Johns Hopkins Hospital,Baltimore,USA;10.Center for Drug Safety and Effectiveness,Johns Hopkins Bloomberg School of Public Health,Baltimore,USA |
| 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. |
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