Performance Measurement Network

Question: Why is a Reason for No VTE Prophylaxis needed with graduated compression stockings (GCS/TEDs)?

Patient admitted 08/04/2010 through the ED with a diagnosis of syncope, mental status changes,and chest pain. MD notes in the H&P the next morning, "CVA with expressive aphasia". On 08/05/2010 the physician orders graduated compression stockings and they are applied the same day. This is reporting as a failed measure for VTE prophylaxis. Can the MD document in the discharge summary a reason for no pharmacological prophylaxis as long as it is within 30 days of discharge or must that documentation be noted the day of or the day after admission.

Answer:

Stroke patients are at greater risk for developing VTE than other medical patients. GCS/TEDs as the sole form of prophylaxis administered is not considered sufficient VTE prophylaxis for stroke patients. That's why the case failed. In order for the case to be included in the numerator, pharmacological prophylaxis or SCDs/IPCs/foot pumps must be administered/applied to the patient on the day of or day after hospital admission OR the physician must document within the timeframe for prophylaxis (day of or day after admission)why GCS were chosen rather than these alternative forms of prophylaxis. See Alphabetical Data Dictionary pdf definition for VTE Prophylaxis for STK-specific guidelines.

http://www.jointcommission.org/PerformanceMeasurement/PerformanceMeasurement/Current+NHQM+Manual.htm

Question Details
Focus area(s): Chart Abstracted Measure Specifications – Clinical, Related Manual - Data Quality Manual
Related documents: STK, STK-01, VTE prophylaxis Appendix: Other
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