title: Prescriber knowledge and attitudes regarding non-administration of prescribed pharmacologic venous thromboembolism prophylaxis.
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.
authors.affiliation: Department of Pharmacy, Johns Hopkins Hospital, 600 North Wolfe Street, Baltimore, MD, 21287, USA. kpiechowski1@gmail.com.
authors.forename: Kara L
authors.initials: KL
authors.lastname: Piechowski
authors.affiliation: Department of Pharmacy, Johns Hopkins Hospital, 600 North Wolfe Street, Baltimore, MD, 21287, USA.
authors.forename: Stacy
authors.initials: S
authors.lastname: Elder
authors.affiliation: Department of Pharmacy, Johns Hopkins Hospital, 600 North Wolfe Street, Baltimore, MD, 21287, USA.
authors.forename: Leigh E
authors.initials: LE
authors.lastname: Efird
authors.affiliation: Division of Acute Care Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.|Armstrong Institute for Patient Safety and Quality, Johns Hopkins University School of Medicine, Baltimore, MD, USA.|Division of Anesthesiology/Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.|Division of Health Policy and Management, Johns Hopkins University School of Public Health, Baltimore, MD, USA.
authors.forename: Elliott R
authors.initials: ER
authors.lastname: Haut
authors.affiliation: Armstrong Institute for Patient Safety and Quality, Johns Hopkins University School of Medicine, Baltimore, MD, USA.|Division of Hematology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Michael B
authors.initials: MB
authors.lastname: Streiff
authors.affiliation: Division of Acute Care Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.|Division of Health Sciences Informatics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Brandyn D
authors.initials: BD
authors.lastname: Lau
authors.affiliation: Department of Pharmacy, Johns Hopkins Hospital, 600 North Wolfe Street, Baltimore, MD, 21287, USA.
authors.forename: Peggy S
authors.initials: PS
authors.lastname: Kraus
authors.affiliation: Pulmonary and Critical Care Medicine Department, Johns Hopkins University, Baltimore, MD, USA.
authors.forename: Cynthia S
authors.initials: CS
authors.lastname: Rand
authors.affiliation: Division of Acute Care Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Victor O
authors.initials: VO
authors.lastname: Popoola
authors.affiliation: Armstrong Institute for Patient Safety and Quality, Johns Hopkins University School of Medicine, Baltimore, MD, USA.|Department of Nursing, Johns Hopkins Hospital, Baltimore, MD, USA.
authors.forename: Deborah B
authors.initials: DB
authors.lastname: Hobson
authors.affiliation: Armstrong Institute for Patient Safety and Quality, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Norma E
authors.initials: NE
authors.lastname: Farrow
authors.affiliation: Armstrong Institute for Patient Safety and Quality, Johns Hopkins University School of Medicine, Baltimore, MD, USA.|Department of Nursing, Johns Hopkins Hospital, Baltimore, MD, USA.
authors.forename: Dauryne
authors.initials: D
authors.lastname: Shaffer
authors.affiliation: Department of Pharmacy, Johns Hopkins Hospital, 600 North Wolfe Street, Baltimore, MD, 21287, USA.|Armstrong Institute for Patient Safety and Quality, Johns Hopkins University School of Medicine, Baltimore, MD, USA.|Center for Drug Safety and Effectiveness, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: Kenneth M
authors.initials: KM
authors.lastname: Shermock
mesh_terms: D011307:Drug Prescriptions; D005260:Female; D006801:Humans; D007396:Internship and Residency; D019359:Knowledge; D008297:Male; D054556:Venous Thromboembolism / Q000517:prevention & control*
keywords: Patient safety; Survey; Thromboembolism; VTE prophylaxis