1. Fyke, Gail L. MSN, RN
  2. Sperry, Frances MBA, CPA

Article Content

Problem and Significance

Venous thromboembolism (VTE) is responsible for 600,000 hospitalizations annually, with an average length of stay of 5.5 days. Pulmonary embolism causes 150,000 to 200,000 deaths per year in the United States despite advances in treatment. Prophylaxis for VTE is 70% to 80% effective when appropriately prescribed. Research reveals that 30% to 38% of patients receive appropriate VTE prophylaxis.



The purpose of this project is to implement a program at our hospital on the basis of national standards that will require 100% of adult inpatients to be assessed for risk of VTE and appropriate prophylaxis initiated.


Description of the Project

Patients will be assessed for VTE risk factors on the basis of guidelines from the American College of Chest Physicians. Patients are then classified as low, moderate, or high risk as determined by their risk factors score. Each risk level has clearly defined recommendations for appropriate interventions.



This project is being implemented through the use of Six Sigma methodology, which is the quality improvement program at our hospital. Chart audits were performed to examine current practice on the nursing units. The audit results were then used in the development of the VTE assessment and intervention tools that will be implemented in the next step of our project.



Effectiveness of the VTE assessment and intervention process will be measured using Six Sigma Control Phase tools. The Control Phase ensures that change in practice is maintained and continually reviewed.


Conclusions/Implications for Nursing

Potential benefits of this project are increased patient safety, reduced complications, and increased customer satisfaction. With the success of the VTE prophylaxis program, nurses and physicians will be shown that Six Sigma methodology is an effective way to introduce innovative solutions to complex problems in the healthcare setting.


Section Description

This year's annual NACNS conference is planned for Orlando, Fla, March 9-12, 2005. Over 300 clinical nurse specialists (CNSs) are expected to attend, and as with past conferences, attendees will also include graduate faculty from CNS programs, nurse administrators, and nurse researchers. The theme of the conference, CNS Leadership: Navigating the Healthcare Environment Toward Excellence, was selected to showcase the many ways CNSs acquire and disseminate knowledge and innovative practices in their specialty areas. Two preconference sessions are scheduled. One session, sponsored by NACNS Legislative/Regulatory Committee, targets information for CNSs interested in understanding the legislative/regulatory process as it deals with the practice of nursing, and will also help build skills CNSs need to engage in the process. The second session, sponsored by NACNS Education Committee, focuses on CNS education issues, and as with the education preconferences of past years, anticipates informative dialogue and much sharing among CNS educators around curriculum design, teaching strategies, and indicators of quality in the curriculum that link to the NACNS education standards to program review and excellence. The conference planning committee is proud and pleased to have Jeanette Ives Erickson, MS, RN, CNA, Senior Vice President for Patient Care Services and Chief Nurse Executive of Massachusetts General Hospital as the opening keynote speaker. She will begin the conference by highlighting the importance of CNS practice on patient safety. The planning committee is equally proud and pleased to have NACNS past-president Rhonda Scott, PhD, RN, Chief Nursing Officer of Grady Health System as the closing speaker. Dr Scott will challenge attendees to use the information from the conference to shape quality care delivered in a safe environment and to advance the profession of nursing through direct care to clients, influencing standards of care delivered by other nurses, and influencing the healthcare delivery system to be to support innovative, cost-effective, quality nursing care. A total of 64 abstracts for podium and poster presentations were selected in addition to graduate student posters. The abstracts address the 3 spheres of CNS practice with a strong emphasis on clinical practice improvements. As you will note from the abstracts published in this issue of the journal, specialty practice areas represented in the abstracts include children, adults, and gerontological patient groups; hospital, outpatient, and home care settings, and community health. In addition, a wide variety of specialty topics including smoking cessation programs, end-of-life care issues, and protocols outlining nursing approaches to improved diabetes, cardiovascular and ventilator management. A number of the abstracts described hospital and healthcare system level innovations that resulted from CNS practice. Collectively, these abstracts reflect the breadth, depth, and richness of CNS contributions to the well-being of individuals, families, groups, and communities. The following abstracts are from those presenters who elected to have their work published in the journal so those who are unable to attend this year's conference can share in the knowledge of the conference. As you read each abstract, consider the talent and clinical scholarship of your CNS colleagues who are advancing the practice of nursing and contributing to improved outcomes for patients and healthcare organizations. You may want to contact individual presenters to network, collaborate, consult, or share your own ideas about these topics. Watch for next year's call for abstracts and consider submitting an abstract for presentation at NACNS's next conference in Salt Lake City, Utah, March 15-18, 2006.