Background: Pediatric venous thromboembolism (VTE), although less common than in adults, is increasingly recognized as a significant and preventable cause of morbidity and mortality. There are no universal pediatric VTE guidelines, although the American College of Chest Physicians (ACCP) limits prophylaxis recommendations to a limited set of risk factors. Multiple centers have published institutional guidelines [...]

Background: Pulmonary embolism (PE) is a frequent cause of hospitalization. It results in significant mortality and morbidity. Several studies have examined the mortality associated with PE and improvements seen with different modalities of treatment. However, other outcomes of PE hospitalization such as length of stay and ICU utilization have not been well-examined. The objective of [...]

Background: We evaluated whether a catheter-to-vein ratio (CVR) of >45% increases the risk of venous thromboembolism [VTE] and catheter occlusion associated with peripherally inserted central catheters (PICCs). Methods: From August 2020 to April 2022, trained abstractors collected demographic and clinical data on patients receiving PICCs while admitted at 52 hospitals participating in the Michigan Hospital [...]

Background: Current national guidelines recommend using mechanical methods for venous thromboembolism (VTE) prophylaxis in hospitalized medical patients at elevated risk for thrombosis who have a contraindication to pharmacologic prophylaxis. Additionally, it is recommended to avoid the use of mechanical prophylaxis for patients who are at low risk for VTE. The Michigan Hospital Medicine Safety Consortium, [...]

Background: Until the advent of novel oral anticoagulants (NOACs), Warfarin was the only oral agent available for the treatment of deep venous thrombosis (DVT) and Pulmonary embolism (PE). Bridging with parenteral anticoagulation until warfarin reaches a full therapeutic level often results in prolonged hospitalization. Rivaroxaban, Dabigatran, Apixaban, Edoxaban were approved by the FDA for DVT [...]

Background: It is widely accepted that hospitalized patients warrant risk assessment for venous thromboembolism (VTE) upon hospital admission. Although many VTE risk assessment models include a patient mobility element for calculating risk, a standardized method of determining mobility is lacking. We sought to determine if physician assessment of anticipated patient mobility upon hospital admission using [...]

Background: Guidelines suggest venous thromboembolism risk stratification, and against use of prophylaxis in low risk medically ill hospitalized patients. Our hospital did not have a formal risk stratification process embedded into the electronic medical record (EMR) for provider use, and therefore it was common practice to administer pharmacologic prophylaxis to most medically ill patients regardless [...]

Background: Risk stratifying patients for potential development of hospital-related venous thromboembolism (VTE) is an important aspect of inpatient safety and is recommended by current guidelines.  Many risk stratification tools are cumbersome and require significant time to complete.  Developments have been made to partially or fully automate risk stratification tools, however there are restrictions within the [...]

Background: Venous thromboembolism (VTE) is a leading cause of preventable in-hospital mortality and a primary focus of quality improvement/patient safety efforts. VTE prophylaxis reduces the incidence of in-hospital VTE, but nonadministration rates—primarily attributed to patient refusal—often reach 10-15%. Notably, nonadministration of VTE prophylaxis may correlate with higher incidence of hospital acquired VTE. Prior studies showed [...]

Background: Venous thromboembolism (VTE) is a preventable and potentially fatal condition for which hospitalized medical patients are at risk. Compared with the more traditional option of unfractionated heparin, low molecular weight heparin (LMWH) has been shown to be superior for VTE prophylaxis with regard to both efficacy and bleeding risk, and to have a lower [...]