Question: VTE Clarification

DOS: 8/12/24-8/18/24 Patient admitted to Inpatient Status 8/13/24 00:26. Identified as Low Risk VTE 8/13/24 00:26.

PNEUMATIC COMPRESSION STOCKINGS ordered to both legs, frequency ongoing, 8/13/24 11:38 by Neurologist.

PNEUMATIC COMPRESSION STOCKINGS discontinued 8/13/24 16:56 by Internal Medicine MD. No reason for discontinuation.

No evidence of application or refusal of IPCs from order time to d/c time on 8/13/24.

Previous guidance from JC 10/16/19 was Low risk does not trump an order for VTE prophylaxis that was not carried out.

PNEUMATIC COMPRESSION STOCKINGS reordered 8/15/24 11:33 by Internal Medicine outside of measure window and no evidence of application or refusal until 8/16.

Would this case pass or fail the measure?

Thank you. Kim

Answer:

Hello. The clinical staff person who answers questions related to this measure is currently unavailable but will respond to your question as soon as possible. Thank you for your patience.

ANSWER: Kim, There is documentation that SCDs were discontinued after the order and documentation of low risk for VTE.

"PNEUMATIC COMPRESSION STOCKINGS discontinued 8/13/24 16:56 by Internal Medicine MD. No reason for discontinuation."

The documentation is within the measurement timeframe of day of or after hospital admission. This should be counted as reason why no VTE prophylaxis was initiated. Discontinuation as a reason is comparable to documentation of no VTE prophylaxis needed.

Patient refusal of SCDs later in the hospital day should be disregarded and not used for abstraction.

Thank you for your inquiry.