title: Development of a guideline for treatment of deep and superficial venous thrombosis in the emergency department.
abstract: Patients with DVT, aged 45.64 years, often present to the ED, with an annual cost of $1.5-$3.2 billion per year. This paper describes the process used to implement an evidence-based guideline on deep venous thrombosis (DVT) for the emergency department (ED). Specific aims were to (a) conduct an organizational assessment of DVT treatment practices; (b) compare organizational results with evidence-based treatment guidelines; (c) develop recommendations for the treatment of DVT for ED discharge; and (d) conduct an interdisciplinary evaluation of the evidence-based guideline. A retrospective review of 149 records of adults in an urban Midwestern ED in 2010 was undertaken. Differences in provider practices were identified. A guideline was developed that included clinical management, social/financial concerns, patient education, anticoagulation monitoring, and outpatient follow-up. Implementation and evaluation were accomplished through electronic and paper communication, medical record monitoring, and patient call back. Evaluation also included simulation exercises with an interdisciplinary team.
authors.affiliation: Emergency Department, Nebraska Methodist Hospital, Omaha, 68114, USA. nancy.tosone@nmhs.org
authors.forename: Nancy C
authors.initials: NC
authors.lastname: Tosone
authors.forename: Cindy
authors.initials: C
authors.lastname: Costanzo
mesh_terms: D000328:Adult; D057179:Advanced Practice Nursing / Q000592:standards; D004632:Emergency Medical Services / Q000379:methods* / Q000592:standards*; D016529:Emergency Nursing / Q000592:standards; D055317:Evidence-Based Practice / Q000592:standards; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009722:Nurse Practitioners / Q000592:standards*; D010348:Patient Care Team / Q000592:standards; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D020246:Venous Thrombosis / Q000175:diagnosis* / Q000628:therapy*