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Purpose: The primary aim of the study is to evaluate the appropriateness of mechanical and pharmacologic venous thromboembolism (VTE) prophylaxis in hospitalized patients before and after the implementation of a computerized prescriber order entry (CPOE) system.
Methods: Medical records of patients admitted before and after CPOE implementation were reviewed. The pre-CPOE group was comprised of a randomized sample of 50 patients (25 high risk and 25 moderate risk) admitted between April 1st, 2011 and May 1st, 2011. The post-CPOE group was comprised a second randomized sample of 50 patients (25 high risk and 25 moderate risk) admitted between August 1st, 2011 and September 1st, 2011. Patients’ demographics, medical histories, VTE risk factors, and VTE prophylaxis regimens were evaluated. Appropriateness of risk stratification and resulting pharmacologic and non-pharmacologic therapy selection upon admission were assessed. The following patients were excluded: less than 18 years of age, pregnancy, length of stay less than 24 hours, and orthopedic surgery.
Results: 30% of high risk and 76% of moderate risk patients in the pre-CPOE cohort were risk stratified appropriately. 48% of high risk and 96% of moderate risk pre-CPOE patients received appropriate VTE prophylaxis. All data will be collected and analyzed before August 31st, 2012.
Conclusion: Initial evaluation has suggested that inappropriate risk assessment and regimen selection is prevalent in pre-CPOE paper-based order set processes. It is possible CPOE can mitigate these deficits. Conclusion is pending completion of data collection of post-CPOE group.