Date of Conferral
Doctor of Nursing Practice (DNP)
Mary T. Verklan
Venous thromboembolism (VTE) is a serious health concern of patients undergoing orthopedic surgery. Analysis of the study site semiannual reports from January 2014 through March 2015 indicated 10 VTE events in 546 orthopedic cases. The community hospital was classed as an outlier performing in the bottom 10th percentile when compared to other hospitals. To standardize the ordering of VTE prophylaxis, the hospital developed a postoperative electronic VTE order set. The purpose of this project was to assess the difference in orthopedic VTE occurrences in the postoperative total hip arthroplasty (THA) patients before and after the implementation of the electronic VTE order set. The goal of the project was to use an electronic retrospective chart review to evaluate if the order set implementation influenced the adherence to ordering mechanical and pharmacological prophylaxis in the THA patient. Differences in the ordering of VTE prophylaxis and VTE outcomes were evaluated using a retrospective review of 325 preimplementation order set cases and 406 postimplementation order set cases. This evaluation demonstrated that appropriate pharmacological prophylaxis ordering increased and orthopedic VTE occurrences decreased after the standardized electronic order set was implemented. Social change occurred through the empowerment of clinicians when empirical evidence was provided for use at the point of care, which positively impacted patient outcomes undergoing a common surgical procedure. VTE is no longer considered a routine postoperative orthopedic complication as technology-enabled solutions have proven to be appropriate tools to combat and prevent postoperative VTE complications.