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A clinical decision support system for venous thromboembolism prophylaxis at a general hospital in a middle-income country ,

OBJECTIVE: To determine the impact that implementing a combination of a computer-based clinical decision support system and a program of training seminars has on the use of appropriate prophylaxis for venous thromboembolism (VTE). METHODS: We conducted a cross-sectional study in two phases (prior to...

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Autores principales: Fuzinatto, Fernanda, de Waldemar, Fernando Starosta, Wajner, André, Elias, Cesar Al Alam, Fernandez, Juliana Fernándes, Hopf, João Luiz de Souza, Barreto, Sergio Saldanha Menna
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Sociedade Brasileira de Pneumologia e Tisiologia 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4075831/
https://www.ncbi.nlm.nih.gov/pubmed/23670498
http://dx.doi.org/10.1590/S1806-37132013000200004
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author Fuzinatto, Fernanda
de Waldemar, Fernando Starosta
Wajner, André
Elias, Cesar Al Alam
Fernandez, Juliana Fernándes
Hopf, João Luiz de Souza
Barreto, Sergio Saldanha Menna
author_facet Fuzinatto, Fernanda
de Waldemar, Fernando Starosta
Wajner, André
Elias, Cesar Al Alam
Fernandez, Juliana Fernándes
Hopf, João Luiz de Souza
Barreto, Sergio Saldanha Menna
author_sort Fuzinatto, Fernanda
collection PubMed
description OBJECTIVE: To determine the impact that implementing a combination of a computer-based clinical decision support system and a program of training seminars has on the use of appropriate prophylaxis for venous thromboembolism (VTE). METHODS: We conducted a cross-sectional study in two phases (prior to and after the implementation of the new VTE prophylaxis protocol) in order to evaluate the impact that the combined strategy had on the use of appropriate VTE prophylaxis. The study was conducted at Nossa Senhora da Conceição Hospital, a general hospital in the city of Porto Alegre, Brazil. We included clinical and surgical patients over 18 years of age who were hospitalized for ≥ 48 h. The pre-implementation and post-implementation phase samples comprised 262 and 261 patients, respectively. RESULTS: The baseline characteristics of the two samples were similar, including the distribution of patients by risk level. Comparing the pre-implementation and post-implementation periods, we found that the overall use of appropriate VTE prophylaxis increased from 46.2% to 57.9% (p = 0.01). Looking at specific patient populations, we observed that the use of appropriate VTE prophylaxis increased more dramatically among cancer patients (from 18.1% to 44.1%; p = 0.002) and among patients with three or more risk factors (from 25.0% to 42.9%; p = 0.008), two populations that benefit most from prophylaxis. CONCLUSIONS: It is possible to increase the use of appropriate VTE prophylaxis in economically constrained settings through the use of a computerized protocol adhered to by trained professionals. The underutilization of prophylaxis continues to be a major problem, indicative of the need for ongoing improvement in the quality of inpatient care.
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spelling pubmed-40758312014-07-16 A clinical decision support system for venous thromboembolism prophylaxis at a general hospital in a middle-income country , Fuzinatto, Fernanda de Waldemar, Fernando Starosta Wajner, André Elias, Cesar Al Alam Fernandez, Juliana Fernándes Hopf, João Luiz de Souza Barreto, Sergio Saldanha Menna J Bras Pneumol Original Article OBJECTIVE: To determine the impact that implementing a combination of a computer-based clinical decision support system and a program of training seminars has on the use of appropriate prophylaxis for venous thromboembolism (VTE). METHODS: We conducted a cross-sectional study in two phases (prior to and after the implementation of the new VTE prophylaxis protocol) in order to evaluate the impact that the combined strategy had on the use of appropriate VTE prophylaxis. The study was conducted at Nossa Senhora da Conceição Hospital, a general hospital in the city of Porto Alegre, Brazil. We included clinical and surgical patients over 18 years of age who were hospitalized for ≥ 48 h. The pre-implementation and post-implementation phase samples comprised 262 and 261 patients, respectively. RESULTS: The baseline characteristics of the two samples were similar, including the distribution of patients by risk level. Comparing the pre-implementation and post-implementation periods, we found that the overall use of appropriate VTE prophylaxis increased from 46.2% to 57.9% (p = 0.01). Looking at specific patient populations, we observed that the use of appropriate VTE prophylaxis increased more dramatically among cancer patients (from 18.1% to 44.1%; p = 0.002) and among patients with three or more risk factors (from 25.0% to 42.9%; p = 0.008), two populations that benefit most from prophylaxis. CONCLUSIONS: It is possible to increase the use of appropriate VTE prophylaxis in economically constrained settings through the use of a computerized protocol adhered to by trained professionals. The underutilization of prophylaxis continues to be a major problem, indicative of the need for ongoing improvement in the quality of inpatient care. Sociedade Brasileira de Pneumologia e Tisiologia 2013 /pmc/articles/PMC4075831/ /pubmed/23670498 http://dx.doi.org/10.1590/S1806-37132013000200004 Text en http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Fuzinatto, Fernanda
de Waldemar, Fernando Starosta
Wajner, André
Elias, Cesar Al Alam
Fernandez, Juliana Fernándes
Hopf, João Luiz de Souza
Barreto, Sergio Saldanha Menna
A clinical decision support system for venous thromboembolism prophylaxis at a general hospital in a middle-income country ,
title A clinical decision support system for venous thromboembolism prophylaxis at a general hospital in a middle-income country ,
title_full A clinical decision support system for venous thromboembolism prophylaxis at a general hospital in a middle-income country ,
title_fullStr A clinical decision support system for venous thromboembolism prophylaxis at a general hospital in a middle-income country ,
title_full_unstemmed A clinical decision support system for venous thromboembolism prophylaxis at a general hospital in a middle-income country ,
title_short A clinical decision support system for venous thromboembolism prophylaxis at a general hospital in a middle-income country ,
title_sort clinical decision support system for venous thromboembolism prophylaxis at a general hospital in a middle-income country ,
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4075831/
https://www.ncbi.nlm.nih.gov/pubmed/23670498
http://dx.doi.org/10.1590/S1806-37132013000200004
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