Order S-1668-3615-8727_Project Presentation

Aspirin as an Efficacious Prophylaxis for Preventing Deep Vein Thrombosis (DVT) after Orthopedic Surgery: An Evidence-Based Practice Project Nicole Rengifo Fairleigh Dickinson University, Teaneck, NJ 07666 Abstract  Deep vein thrombosis (DVT) and Pulmonary Embolism (PE) are severe complications of orthopedic surgery  It is imperative to develop evidence- based practice (EBP) guidelines to reduce the risk Statement of the EBP Problem  There is lack of consensus regarding the most efficacious prophylactic agent for Deep Vein Thrombosis  The regional hospital also lacks a uniform policy on the use of prophylactic regimens for preventing DVT Purpose Statement The purpose of this review is to develop a standardized evidence-based protocol that recommends aspirin as the first-line DVT prophylaxis PICO Question In the adult population undergoing elective joint replacement surgery (P) , is Aspirin (I) compared to Coumadin (C) more efficacious in preventing deep vein thrombosis and bleeding (O) 3-5 days postoperatively (T) ? Implementation Model  The IOWA model will guide the implementation process by emphasizing organization and collaboration in conducting and using research Integration of Evidence  The regional orthopedic hospital is developing a clinical improvement project  The QI proposal acknowledges the clinical implications of venous thromboembolism (VTE)  Administrators and clinicians have endorsed the need for a standardized prophylaxis protocol for VTE EBP Setting  A 24-bed orthopedic unit of a regional hospital in New Jersey Implementation Procedures  Formation of an implementation team consisting of all stakeholders  Bottom-up and participatory approach to decision-making process and implementation Facilitating Factors  Organizational support, teamwork and effectual communication Barriers to Implementation  Resistance to change, limited knowledge, and paper-based systems Data Collection/Management  Data collection form and interviews with stakeholders  Quality Improvement (QI) team to manage the data Data Analysis/Interpretation • Analysis of data using descriptive and inferential statistics • Interpretation of data using performance and outcome benchmarks Summary  Standardized approach to DVT prophylaxis  Periodic assessment to support continuous quality improvement References Becattini, C. et al. (2012). Aspirin for the prevention of recurrence of venous thromboembolism. New England Journal of Medicine, 366 (21), 1959-1967. Bozic, K. J. et al. (2010). Does aspirin have a role in venous thromboembolism prophylaxis in total knee arthroplasty patients? Journal of Arthroplasty, 25 (7), 1053–1060. Simes, J. et al. (2014). Aspirin for the prevention of recurrent venous thromboembolism: The INSPIRE collaboration. Circulation, 130, 1062-1071. Woller, S. C. et al. (2012). A prospective comparison of warfarin to aspirin for thromboprophylaxis in total hip and total knee arthroplasty. The Journal of Arthroplasty, 27 (1), 1–9.