Intensive Care Unit Venous Thromboembolism Prophylaxis
This measure assesses the number of patients who received VTE prophylaxis or have documentation why no VTE prophylaxis was given the day of or the day after the initial admission (or transfer) to the Intensive Care Unit (ICU) or surgery end date for surgeries that start the day of or the day after ICU admission (or transfer).
Joint Commission
Joint Commission
National Quality Forum
Finalized Date/Time
Measure specifications are in the Public Domain
LOINC(R) is a registered trademark of the Regenstrief Institute.
This material contains SNOMED Clinical Terms(R) (SNOMED CT(c)) copyright 2004–2010 International Health Terminology Standards Development Organization. All rights reserved.
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Approximately two-thirds of cases of Deep Vein Thrombosis (DVT) or Pulmonary Emboli (PE) are associated with recent hospitalization. This is consistent with the 2001 report by Agency for Healthcare Research and Quality (Shojania, et al., 2001). AHRQ reports that “the appropriate application of effective preventive measures in hospitals has major potential for improving patient safety, by reducing the incidence of VTE.”
Almost all hospitalized patients have at least one risk factor for Venous Thromboembolism (VTE), and approximately 40% have three or more risk factors. Without thromboprophylaxis, the incidence of objectively confirmed, hospital-acquired DVT is approximately 10% to 40% among medical or general surgical patients and 40% to 60% following major orthopedic surgery (Geerts et al., 2008).
Commonly, criteria for admission to the Intensive Care Unit (ICU) itself, puts patient’s at an increased risk for developing VTE, and subsequent increased risk of morbidity from PE. Some risk factors are related to the acute illness present that allowed for the admission to the ICU unit, and some risk factors may be acquired during the ICU admission due to subsequent medical treatments, for example limitations of mobility, presence of central venous lines or mechanical ventilation and subsequent pharmacological paralysis. Reports of DVT in the population of ICU patients vary in relation to the acuity of the illness in this population. DVT in ICU patients diagnosed with routine venography or Doppler ultrasound found ranges between 10% to 100%. Five studies prospectively screened patients who were not receiving thromboprophylaxis during their ICU stays. The rates of DVT using Fibrinogen Uptake Test, Doppler Ultrasound or venography ranged from 13 to 31% (Geerts et al., 2008). It is essential for all ICUs to assess each patient upon admission to the ICU unit, a change in level of status, for the need for VTE prophylaxis due to the above increased development of risk factors (Geerts, et al., 2004).
Failure to recognize and protect patients at risk for venous thromboembolism (VTE) increases the chances for critically ill hospitalized patients for developing a deep vein thrombosis or dying from a pulmonary emboli. Screening all patients is the only evidence based practice in reducing incidence of disease. All intensive care unit (ICU) patients should be evaluated for primary VTE prophylaxis, and given appropriate prophylaxis when indicated.
An increase in the rate
NQF ID Number
Disclaimer
These performance measures are not clinical guidelines and do not establish a standard of medical care, and have not been tested for all potential applications. The measures and specifications are provided without warranty.
eMeasure Identifier
190
measureStartDate
measureEndDate
Geerts WH, Bergqvist D, Pineo GF, Heit JA, Samama CM, Lassen MR, Colwell CW. Prevention of venous thromboembolism. The Eighth ACCP Conference on antithrombotic and thrombolytic therapy. Chest. 2008; 133:381S-453S.
Geerts WH, Pineo GF, Heit JA, et al. Prevention of venous thromboembolism: the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest. 2004 Sep;126(3 Suppl):338S-400S.
Guyatt, G.H., Akl, E.A., Crowther, M., Gutterman, D., Schunemann, H. Antithrombotic Therapy and Prevention of Thrombosis, 9th edition: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. CHEST 2012; 141(2) (Supp):7S-47S.
Shojania KG, Duncan BW, McDonald DM, et al. (Eds.). (2001). Making healthcare safer; A critical analysis of patient safety practices (Evidence Report/Technology Assessment No. 43). Prepared by the University of California at San Francisco-Stanford Evidenced-based Practice Center under Contract no. 290-97-0013 (AHRQ Publication NO.01-E058). Rockville, MD:Agency for Healthcare Research and Quality.
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The unit of measurement for this measure is an inpatient episode of care. Each distinct hospitalization should be reported, regardless of whether the same patient is admitted for inpatient care more than once during the measurement period. In addition, the eMeasure logic intends to represent events within or surrounding a single occurrence of an inpatient hospitalization.
The definition of an ICU for the purpose of the measures noted above is that used by the CDC in the NHSN Patient Safety Project. An intensive care unit can be defined as a nursing care area that provides intensive observation, diagnosis, and therapeutic procedures for adults and/or children who are critically ill. An ICU excludes nursing areas that provide step-down, intermediate care or telemetry only and specialty care areas.
The construct of Unfractionated Heparin (route: 'Intravenous route') intends to capture continually infused heparin rather than heparin flushes or pushes.
Transmission Format
None
Initial Patient Population
Patient age 18 and older discharged from hospital inpatient acute care with no diagnosis for obstetrics or venous thromboembolism (VTE) and a length of stay less than or equal to 120 days.
Denominator
Patients directly admitted or transferred to ICU during the hospitalization.
Denominator Exclusions
Patients who have a hospital length of stay (LOS) less than two days.
Patients with comfort measures only documented during the specified date range.
Patients with a principal procedure of surgical care improvement Project (SCIP) VTE selected surgeries that start the day of or the day after ICU admission or transfer.
Numerator
Patients who received VTE prophylaxis or have documentation why no VTE prophylaxis was given:
-the day of or the day after ICU admission (or transfer)
-the day of or the day after surgery end date for surgeries that start the day of or the day after ICU admission (or transfer)
Numerator Exclusions
Not Applicable
Denominator Exceptions
Patients with ICU LOS less than one day without VTE prophylaxis administered and documentation for no VTE prophylaxis.
Measure Population
Not Applicable
Measure Observations
Not Applicable
Supplemental Data Elements
For every patient evaluated by this measure also identify payer, race, ethnicity and sex.
eMeasure Venous Thromboembolism (eVTE)
Population criteria
-
Initial Patient Population =
- AND: "Patient Characteristic Birthdate: birth date" >= 18 year(s) starts before start of "Occurrence A of Encounter, Performed: Encounter Inpatient"
- AND: "Occurrence A of Encounter, Performed: Encounter Inpatient (length of stay <= 120 day(s))"
- AND: "Occurrence A of Encounter, Performed: Encounter Inpatient" ends during "Measurement Period"
- AND NOT:
- OR: "Diagnosis, Active: Obstetrics"
- OR: "Diagnosis, Active: Venous Thromboembolism"
- OR: "Diagnosis, Active: Obstetrics VTE"
- starts during "Occurrence A of Encounter, Performed: Encounter Inpatient"
-
Denominator =
- AND: "Initial Patient Population"
- AND: FIRST: "Occurrence A of Encounter, Performed: ICU Admission or Transfer" during "Occurrence A of Encounter, Performed: Encounter Inpatient"
-
Denominator Exclusions =
- AND:
- OR: "Occurrence A of Encounter, Performed: Encounter Inpatient (length of stay < 2 day(s))"
- OR:
- OR: "Procedure, Performed: Intracranial Neurosurgery (ordinality: 'Principal')"
- OR: "Procedure, Performed: General Surgery (ordinality: 'Principal')"
- OR: "Procedure, Performed: Gynecological Surgery (ordinality: 'Principal')"
- OR: "Procedure, Performed: Hip Fracture Surgery (ordinality: 'Principal')"
- OR: "Procedure, Performed: Hip Replacement Surgery (ordinality: 'Principal')"
- OR: "Procedure, Performed: Knee Replacement Surgery (ordinality: 'Principal')"
- OR: "Procedure, Performed: Urological Surgery (ordinality: 'Principal')"
- <= 1 day(s) ends after start of "Occurrence A of Encounter, Performed: ICU Admission or Transfer"
- OR:
- OR:
- AND:
- OR: "Intervention, Order: Comfort Measures"
- OR: "Intervention, Performed: Comfort Measures"
- starts after start of "Occurrence A of Encounter, Performed: Encounter Inpatient"
- AND:
- OR: "Intervention, Order: Comfort Measures"
- OR: "Intervention, Performed: Comfort Measures"
- <= 1 day(s) starts after start of "Occurrence A of Encounter, Performed: ICU Admission or Transfer"
- OR:
- OR: "Intervention, Order: Comfort Measures"
- OR: "Intervention, Performed: Comfort Measures"
- <= 1 day(s) starts after end of ("Procedure, Performed: General or Neuraxial Anesthesia" <= 1 day(s) ends after start of "Occurrence A of Encounter, Performed: ICU Admission or Transfer")
- OR:
- AND: "Occurrence A of Encounter, Performed: Encounter Inpatient" <= 1 hour(s) starts after end of "Occurrence A of Encounter, Performed: Emergency Department Visit"
- AND:
- OR: "Intervention, Order: Comfort Measures"
- OR: "Intervention, Performed: Comfort Measures"
- <= 1 day(s) starts after start of "Occurrence A of Encounter, Performed: Emergency Department Visit"
-
Numerator =
- AND:
- OR:
- OR: "Medication, Administered: Low Dose Unfractionated Heparin for VTE Prophylaxis (route: 'Subcutaneous route')"
- OR: "Medication, Administered: Injectable Factor Xa Inhibitor for VTE Prophylaxis"
- OR: "Medication, Administered: Low Molecular Weight Heparin for VTE Prophylaxis"
- OR: "Medication, Administered: Warfarin"
- OR: "Device, Applied: Intermittent pneumatic compression devices (IPC)"
- OR: "Device, Applied: Venous foot pumps (VFP)"
- OR: "Device, Applied: Graduated compression stockings (GCS)"
- OR: "Risk Category Assessment: VTE Risk Assessment (result: 'Low Risk')"
- <= 1 day(s) starts after start of "Occurrence A of Encounter, Performed: ICU Admission or Transfer"
- OR:
- OR: "Medication, Administered: Low Dose Unfractionated Heparin for VTE Prophylaxis (route: 'Subcutaneous route')"
- OR: "Medication, Administered: Injectable Factor Xa Inhibitor for VTE Prophylaxis"
- OR: "Medication, Administered: Low Molecular Weight Heparin for VTE Prophylaxis"
- OR: "Medication, Administered: Warfarin"
- OR: "Device, Applied: Intermittent pneumatic compression devices (IPC)"
- OR: "Device, Applied: Venous foot pumps (VFP)"
- OR: "Device, Applied: Graduated compression stockings (GCS)"
- OR: "Risk Category Assessment: VTE Risk Assessment (result: 'Low Risk')"
- <= 1 day(s) starts after end of ("Procedure, Performed: General or Neuraxial Anesthesia" <= 1 day(s) ends after start of "Occurrence A of Encounter, Performed: ICU Admission or Transfer")
- OR:
- OR:
- AND:
- OR: "Medication, Administered not done: Medical Reason" for "Low Dose Unfractionated Heparin for VTE Prophylaxis "
- OR: "Medication, Administered not done: Medical Reason" for "Low Molecular Weight Heparin for VTE Prophylaxis "
- OR: "Medication, Administered not done: Medical Reason" for "Injectable Factor Xa Inhibitor for VTE Prophylaxis "
- OR: "Medication, Administered not done: Medical Reason" for "Warfarin "
- OR: "Medication, Order not done: Medical Reason" for "Unfractionated Heparin for VTE prophylaxis ingredient specific "
- OR: "Medication, Order not done: Medical Reason" for "Low Molecular Weight Heparin for VTE prophylaxis ingredient specific "
- OR: "Medication, Order not done: Medical Reason" for "Injectable factor Xa inhibitor for VTE prophylaxis ingredient specific "
- OR: "Medication, Order not done: Medical Reason" for "Warfarin-only ingredient specific "
- AND:
- OR: "Device, Applied not done: Medical Reason" for "Intermittent pneumatic compression devices (IPC) "
- OR: "Device, Applied not done: Medical Reason" for "Venous foot pumps (VFP) "
- OR: "Device, Applied not done: Medical Reason" for "Graduated compression stockings (GCS) "
- OR: "Device, Order not done: Medical Reason" for "Intermittent pneumatic compression devices (IPC) "
- OR: "Device, Order not done: Medical Reason" for "Venous foot pumps (VFP) "
- OR: "Device, Order not done: Medical Reason" for "Graduated compression stockings (GCS) "
- <= 1 day(s) starts after start of "Occurrence A of Encounter, Performed: ICU Admission or Transfer"
- OR:
- AND:
- OR: "Medication, Administered not done: Medical Reason" for "Low Dose Unfractionated Heparin for VTE Prophylaxis "
- OR: "Medication, Administered not done: Medical Reason" for "Low Molecular Weight Heparin for VTE Prophylaxis "
- OR: "Medication, Administered not done: Medical Reason" for "Injectable Factor Xa Inhibitor for VTE Prophylaxis "
- OR: "Medication, Administered not done: Medical Reason" for "Warfarin "
- OR: "Medication, Order not done: Medical Reason" for "Unfractionated Heparin for VTE prophylaxis ingredient specific "
- OR: "Medication, Order not done: Medical Reason" for "Low Molecular Weight Heparin for VTE prophylaxis ingredient specific "
- OR: "Medication, Order not done: Medical Reason" for "Injectable factor Xa inhibitor for VTE prophylaxis ingredient specific "
- OR: "Medication, Order not done: Medical Reason" for "Warfarin-only ingredient specific "
- AND:
- OR: "Device, Applied not done: Medical Reason" for "Intermittent pneumatic compression devices (IPC) "
- OR: "Device, Applied not done: Medical Reason" for "Venous foot pumps (VFP) "
- OR: "Device, Applied not done: Medical Reason" for "Graduated compression stockings (GCS) "
- OR: "Device, Order not done: Medical Reason" for "Intermittent pneumatic compression devices (IPC) "
- OR: "Device, Order not done: Medical Reason" for "Venous foot pumps (VFP) "
- OR: "Device, Order not done: Medical Reason" for "Graduated compression stockings (GCS) "
- <= 1 day(s) starts after end of ("Procedure, Performed: General or Neuraxial Anesthesia" <= 1 day(s) ends after start of "Occurrence A of Encounter, Performed: ICU Admission or Transfer")
- OR:
- OR: "Laboratory Test, Result: INR (result > 3 )"
- OR: "Medication, Administered: Unfractionated Heparin (route: 'Intravenous route')"
- OR: "Medication, Administered: Glycoprotein IIb/IIIa Inhibitors"
- OR: "Medication, Administered: Direct Thrombin Inhibitor"
- <= 1 day(s) starts after end of ("Procedure, Performed: General or Neuraxial Anesthesia" <= 1 day(s) ends after start of "Occurrence A of Encounter, Performed: ICU Admission or Transfer")
- OR:
- OR: "Laboratory Test, Result: INR (result > 3 )"
- OR: "Medication, Administered: Unfractionated Heparin (route: 'Intravenous route')"
- OR: "Medication, Administered: Glycoprotein IIb/IIIa Inhibitors"
- OR: "Medication, Administered: Direct Thrombin Inhibitor"
- <= 1 day(s) starts after start of "Occurrence A of Encounter, Performed: ICU Admission or Transfer"
- OR:
- OR:
- OR: "Medication, Administered not done: Patient Refusal" for "Low Dose Unfractionated Heparin for VTE Prophylaxis "
- OR: "Medication, Administered not done: Patient Refusal" for "Low Molecular Weight Heparin for VTE Prophylaxis "
- OR: "Medication, Administered not done: Patient Refusal" for "Injectable Factor Xa Inhibitor for VTE Prophylaxis "
- OR: "Medication, Administered not done: Patient Refusal" for "Warfarin "
- OR: "Device, Applied not done: Patient Refusal" for "Intermittent pneumatic compression devices (IPC) "
- OR: "Device, Applied not done: Patient Refusal" for "Venous foot pumps (VFP) "
- OR: "Device, Applied not done: Patient Refusal" for "Graduated compression stockings (GCS) "
- OR:
- OR: "Medication, Order not done: Patient Refusal" for "Unfractionated Heparin for VTE prophylaxis ingredient specific "
- OR: "Medication, Order not done: Patient Refusal" for "Low Molecular Weight Heparin for VTE prophylaxis ingredient specific "
- OR: "Medication, Order not done: Patient Refusal" for "Injectable factor Xa inhibitor for VTE prophylaxis ingredient specific "
- OR: "Medication, Order not done: Patient Refusal" for "Warfarin-only ingredient specific "
- OR: "Device, Order not done: Patient Refusal" for "Intermittent pneumatic compression devices (IPC) "
- OR: "Device, Order not done: Patient Refusal" for "Venous foot pumps (VFP) "
- OR: "Device, Order not done: Patient Refusal" for "Graduated compression stockings (GCS) "
- <= 1 day(s) starts after end of ("Procedure, Performed: General or Neuraxial Anesthesia" <= 1 day(s) ends after start of "Occurrence A of Encounter, Performed: ICU Admission or Transfer")
- OR:
- OR:
- OR: "Medication, Administered not done: Patient Refusal" for "Low Dose Unfractionated Heparin for VTE Prophylaxis "
- OR: "Medication, Administered not done: Patient Refusal" for "Low Molecular Weight Heparin for VTE Prophylaxis "
- OR: "Medication, Administered not done: Patient Refusal" for "Injectable Factor Xa Inhibitor for VTE Prophylaxis "
- OR: "Medication, Administered not done: Patient Refusal" for "Warfarin "
- OR: "Device, Applied not done: Patient Refusal" for "Intermittent pneumatic compression devices (IPC) "
- OR: "Device, Applied not done: Patient Refusal" for "Venous foot pumps (VFP) "
- OR: "Device, Applied not done: Patient Refusal" for "Graduated compression stockings (GCS) "
- OR:
- OR: "Medication, Order not done: Patient Refusal" for "Unfractionated Heparin for VTE prophylaxis ingredient specific "
- OR: "Medication, Order not done: Patient Refusal" for "Low Molecular Weight Heparin for VTE prophylaxis ingredient specific "
- OR: "Medication, Order not done: Patient Refusal" for "Injectable factor Xa inhibitor for VTE prophylaxis ingredient specific "
- OR: "Medication, Order not done: Patient Refusal" for "Warfarin-only ingredient specific "
- OR: "Device, Order not done: Patient Refusal" for "Intermittent pneumatic compression devices (IPC) "
- OR: "Device, Order not done: Patient Refusal" for "Venous foot pumps (VFP) "
- OR: "Device, Order not done: Patient Refusal" for "Graduated compression stockings (GCS) "
- <= 1 day(s) starts after start of "Occurrence A of Encounter, Performed: ICU Admission or Transfer"
- OR:
- AND:
- OR: "Medication, Administered: Oral Factor Xa Inhibitor for VTE Prophylaxis" <= 1 day(s) starts after start of "Occurrence A of Encounter, Performed: ICU Admission or Transfer"
- OR: "Medication, Administered: Oral Factor Xa Inhibitor for VTE Prophylaxis" <= 1 day(s) starts after end of ("Procedure, Performed: General or Neuraxial Anesthesia" <= 1 day(s) ends after start of "Occurrence A of Encounter, Performed: ICU Admission or Transfer")
- AND:
- OR: "Diagnosis, Active: Atrial Fibrillation/Flutter" starts before or during "Occurrence A of Encounter, Performed: Encounter Inpatient"
- OR: "Diagnosis, Inactive: Atrial Fibrillation/Flutter" starts before start of "Occurrence A of Encounter, Performed: Encounter Inpatient"
- OR:
- OR: "Procedure, Performed: Hip Replacement Surgery"
- OR: "Procedure, Performed: Knee Replacement Surgery"
- starts before or during "Occurrence A of Encounter, Performed: Encounter Inpatient"
- OR:
- OR: "Diagnosis, Active: Venous Thromboembolism"
- OR: "Diagnosis, Inactive: Venous Thromboembolism"
- starts before start of "Occurrence A of Encounter, Performed: Encounter Inpatient"
-
Denominator Exceptions =
- AND: "Occurrence A of Encounter, Performed: ICU Admission or Transfer (length of stay < 1 day(s))"
Patient Characteristic Birthdate: birth date
Occurrence A of Encounter, Performed: Encounter Inpatient
Occurrence A of Encounter, Performed: Encounter Inpatient (length of stay <= 120 day(s))
Occurrence A of Encounter, Performed: Encounter Inpatient
Measurement Period
Diagnosis, Active: Obstetrics
Diagnosis, Active: Venous Thromboembolism
Diagnosis, Active: Obstetrics VTE
Occurrence A of Encounter, Performed: Encounter Inpatient
Initial Patient Population
Occurrence A of Encounter, Performed: ICU Admission or Transfer
Occurrence A of Encounter, Performed: Encounter Inpatient
Initial Patient Population
Occurrence A of Encounter, Performed: Encounter Inpatient (length of stay < 2 day(s))
Procedure, Performed: Intracranial Neurosurgery (ordinality: 'Principal')
Procedure, Performed: General Surgery (ordinality: 'Principal')
Procedure, Performed: Gynecological Surgery (ordinality: 'Principal')
Procedure, Performed: Hip Fracture Surgery (ordinality: 'Principal')
Procedure, Performed: Hip Replacement Surgery (ordinality: 'Principal')
Procedure, Performed: Knee Replacement Surgery (ordinality: 'Principal')
Procedure, Performed: Urological Surgery (ordinality: 'Principal')
Occurrence A of Encounter, Performed: ICU Admission or Transfer
Intervention, Order: Comfort Measures
Intervention, Performed: Comfort Measures
Occurrence A of Encounter, Performed: Encounter Inpatient
Intervention, Order: Comfort Measures
Intervention, Performed: Comfort Measures
Occurrence A of Encounter, Performed: ICU Admission or Transfer
Intervention, Order: Comfort Measures
Intervention, Performed: Comfort Measures
Procedure, Performed: General or Neuraxial Anesthesia
Occurrence A of Encounter, Performed: ICU Admission or Transfer
Occurrence A of Encounter, Performed: Encounter Inpatient
Occurrence A of Encounter, Performed: Emergency Department Visit
Intervention, Order: Comfort Measures
Intervention, Performed: Comfort Measures
Occurrence A of Encounter, Performed: Emergency Department Visit
Denominator
Occurrence A of Encounter, Performed: ICU Admission or Transfer (length of stay < 1 day(s))
Denominator
Medication, Administered: Low Dose Unfractionated Heparin for VTE Prophylaxis (route: 'Subcutaneous route')
Medication, Administered: Injectable Factor Xa Inhibitor for VTE Prophylaxis
Medication, Administered: Low Molecular Weight Heparin for VTE Prophylaxis
Medication, Administered: Warfarin
Device, Applied: Intermittent pneumatic compression devices (IPC)
Device, Applied: Venous foot pumps (VFP)
Device, Applied: Graduated compression stockings (GCS)
Risk Category Assessment: VTE Risk Assessment (result: 'Low Risk')
Occurrence A of Encounter, Performed: ICU Admission or Transfer
Medication, Administered: Low Dose Unfractionated Heparin for VTE Prophylaxis (route: 'Subcutaneous route')
Medication, Administered: Injectable Factor Xa Inhibitor for VTE Prophylaxis
Medication, Administered: Low Molecular Weight Heparin for VTE Prophylaxis
Medication, Administered: Warfarin
Device, Applied: Intermittent pneumatic compression devices (IPC)
Device, Applied: Venous foot pumps (VFP)
Device, Applied: Graduated compression stockings (GCS)
Risk Category Assessment: VTE Risk Assessment (result: 'Low Risk')
Procedure, Performed: General or Neuraxial Anesthesia
Occurrence A of Encounter, Performed: ICU Admission or Transfer
Medication, Administered not done: Medical Reason
Medication, Administered not done: Medical Reason
Medication, Administered not done: Medical Reason
Medication, Administered not done: Medical Reason
Medication, Order not done: Medical Reason
Medication, Order not done: Medical Reason
Medication, Order not done: Medical Reason
Medication, Order not done: Medical Reason
Device, Applied not done: Medical Reason
Device, Applied not done: Medical Reason
Device, Applied not done: Medical Reason
Device, Order not done: Medical Reason
Device, Order not done: Medical Reason
Device, Order not done: Medical Reason
Occurrence A of Encounter, Performed: ICU Admission or Transfer
Medication, Administered not done: Medical Reason
Medication, Administered not done: Medical Reason
Medication, Administered not done: Medical Reason
Medication, Administered not done: Medical Reason
Medication, Order not done: Medical Reason
Medication, Order not done: Medical Reason
Medication, Order not done: Medical Reason
Medication, Order not done: Medical Reason
Device, Applied not done: Medical Reason
Device, Applied not done: Medical Reason
Device, Applied not done: Medical Reason
Device, Order not done: Medical Reason
Device, Order not done: Medical Reason
Device, Order not done: Medical Reason
Procedure, Performed: General or Neuraxial Anesthesia
Occurrence A of Encounter, Performed: ICU Admission or Transfer
Laboratory Test, Result: INR (result > 3 )
Medication, Administered: Unfractionated Heparin (route: 'Intravenous route')
Medication, Administered: Glycoprotein IIb/IIIa Inhibitors
Medication, Administered: Direct Thrombin Inhibitor
Procedure, Performed: General or Neuraxial Anesthesia
Occurrence A of Encounter, Performed: ICU Admission or Transfer
Laboratory Test, Result: INR (result > 3 )
Medication, Administered: Unfractionated Heparin (route: 'Intravenous route')
Medication, Administered: Glycoprotein IIb/IIIa Inhibitors
Medication, Administered: Direct Thrombin Inhibitor
Occurrence A of Encounter, Performed: ICU Admission or Transfer
Medication, Administered not done: Patient Refusal
Medication, Administered not done: Patient Refusal
Medication, Administered not done: Patient Refusal
Medication, Administered not done: Patient Refusal
Device, Applied not done: Patient Refusal
Device, Applied not done: Patient Refusal
Device, Applied not done: Patient Refusal
Medication, Order not done: Patient Refusal
Medication, Order not done: Patient Refusal
Medication, Order not done: Patient Refusal
Medication, Order not done: Patient Refusal
Device, Order not done: Patient Refusal
Device, Order not done: Patient Refusal
Device, Order not done: Patient Refusal
Procedure, Performed: General or Neuraxial Anesthesia
Occurrence A of Encounter, Performed: ICU Admission or Transfer
Medication, Administered not done: Patient Refusal
Medication, Administered not done: Patient Refusal
Medication, Administered not done: Patient Refusal
Medication, Administered not done: Patient Refusal
Device, Applied not done: Patient Refusal
Device, Applied not done: Patient Refusal
Device, Applied not done: Patient Refusal
Medication, Order not done: Patient Refusal
Medication, Order not done: Patient Refusal
Medication, Order not done: Patient Refusal
Medication, Order not done: Patient Refusal
Device, Order not done: Patient Refusal
Device, Order not done: Patient Refusal
Device, Order not done: Patient Refusal
Occurrence A of Encounter, Performed: ICU Admission or Transfer
Medication, Administered: Oral Factor Xa Inhibitor for VTE Prophylaxis
Occurrence A of Encounter, Performed: ICU Admission or Transfer
Medication, Administered: Oral Factor Xa Inhibitor for VTE Prophylaxis
Procedure, Performed: General or Neuraxial Anesthesia
Occurrence A of Encounter, Performed: ICU Admission or Transfer
Diagnosis, Active: Atrial Fibrillation/Flutter
Occurrence A of Encounter, Performed: Encounter Inpatient
Diagnosis, Inactive: Atrial Fibrillation/Flutter
Occurrence A of Encounter, Performed: Encounter Inpatient
Procedure, Performed: Hip Replacement Surgery
Procedure, Performed: Knee Replacement Surgery
Occurrence A of Encounter, Performed: Encounter Inpatient
Diagnosis, Active: Venous Thromboembolism
Diagnosis, Inactive: Venous Thromboembolism
Occurrence A of Encounter, Performed: Encounter Inpatient
Data criteria (QDM Data Elements)
-
"Device, Applied not done: Medical Reason" using "Medical Reason SNOMEDCT Value Set (2.16.840.1.113883.3.117.1.7.1.473)"
-
"Device, Applied not done: Medical Reason" using "Medical Reason SNOMEDCT Value Set (2.16.840.1.113883.3.117.1.7.1.473)"
-
"Device, Applied not done: Medical Reason" using "Medical Reason SNOMEDCT Value Set (2.16.840.1.113883.3.117.1.7.1.473)"
-
"Device, Applied not done: Patient Refusal" using "Patient Refusal SNOMEDCT Value Set (2.16.840.1.113883.3.117.1.7.1.93)"
-
"Device, Applied not done: Patient Refusal" using "Patient Refusal SNOMEDCT Value Set (2.16.840.1.113883.3.117.1.7.1.93)"
-
"Device, Applied not done: Patient Refusal" using "Patient Refusal SNOMEDCT Value Set (2.16.840.1.113883.3.117.1.7.1.93)"
-
"Device, Applied: Graduated compression stockings (GCS)" using "Graduated compression stockings (GCS) SNOMEDCT Value Set (2.16.840.1.113883.3.117.1.7.1.256)"
-
"Device, Applied: Intermittent pneumatic compression devices (IPC)" using "Intermittent pneumatic compression devices (IPC) SNOMEDCT Value Set (2.16.840.1.113883.3.117.1.7.1.214)"
-
"Device, Applied: Venous foot pumps (VFP)" using "Venous foot pumps (VFP) SNOMEDCT Value Set (2.16.840.1.113883.3.117.1.7.1.230)"
-
"Device, Order not done: Medical Reason" using "Medical Reason SNOMEDCT Value Set (2.16.840.1.113883.3.117.1.7.1.473)"
-
"Device, Order not done: Medical Reason" using "Medical Reason SNOMEDCT Value Set (2.16.840.1.113883.3.117.1.7.1.473)"
-
"Device, Order not done: Medical Reason" using "Medical Reason SNOMEDCT Value Set (2.16.840.1.113883.3.117.1.7.1.473)"
-
"Device, Order not done: Patient Refusal" using "Patient Refusal SNOMEDCT Value Set (2.16.840.1.113883.3.117.1.7.1.93)"
-
"Device, Order not done: Patient Refusal" using "Patient Refusal SNOMEDCT Value Set (2.16.840.1.113883.3.117.1.7.1.93)"
-
"Device, Order not done: Patient Refusal" using "Patient Refusal SNOMEDCT Value Set (2.16.840.1.113883.3.117.1.7.1.93)"
-
"Device, Order: Graduated compression stockings (GCS)" using "Graduated compression stockings (GCS) SNOMEDCT Value Set (2.16.840.1.113883.3.117.1.7.1.256)"
-
"Device, Order: Intermittent pneumatic compression devices (IPC)" using "Intermittent pneumatic compression devices (IPC) SNOMEDCT Value Set (2.16.840.1.113883.3.117.1.7.1.214)"
-
"Device, Order: Venous foot pumps (VFP)" using "Venous foot pumps (VFP) SNOMEDCT Value Set (2.16.840.1.113883.3.117.1.7.1.230)"
-
"Diagnosis, Active: Atrial Fibrillation/Flutter" using "Atrial Fibrillation/Flutter Grouping Value Set (2.16.840.1.113883.3.117.1.7.1.202)"
-
"Diagnosis, Active: Obstetrics" using "Obstetrics Grouping Value Set (2.16.840.1.113883.3.117.1.7.1.263)"
-
"Diagnosis, Active: Obstetrics VTE" using "Obstetrics VTE Grouping Value Set (2.16.840.1.113883.3.117.1.7.1.264)"
-
"Diagnosis, Active: Venous Thromboembolism" using "Venous Thromboembolism Grouping Value Set (2.16.840.1.113883.3.117.1.7.1.279)"
-
"Diagnosis, Inactive: Atrial Fibrillation/Flutter" using "Atrial Fibrillation/Flutter Grouping Value Set (2.16.840.1.113883.3.117.1.7.1.202)"
-
"Diagnosis, Inactive: Venous Thromboembolism" using "Venous Thromboembolism Grouping Value Set (2.16.840.1.113883.3.117.1.7.1.279)"
-
"Encounter, Performed: Emergency Department Visit" using "Emergency Department Visit SNOMEDCT Value Set (2.16.840.1.113883.3.117.1.7.1.292)"
-
"Encounter, Performed: Encounter Inpatient" using "Encounter Inpatient SNOMEDCT Value Set (2.16.840.1.113883.3.666.5.307)"
-
"Encounter, Performed: ICU Admission or Transfer" using "ICU Admission or Transfer SNOMEDCT Value Set (2.16.840.1.113883.3.117.1.7.1.305)"
-
"Intervention, Order: Comfort Measures " using "Comfort Measures SNOMEDCT Value Set (1.3.6.1.4.1.33895.1.3.0.45)"
-
"Intervention, Performed: Comfort Measures " using "Comfort Measures SNOMEDCT Value Set (1.3.6.1.4.1.33895.1.3.0.45)"
-
"Laboratory Test, Result: INR" using "INR LOINC Value Set (2.16.840.1.113883.3.117.1.7.1.213)"
-
"Medication, Administered not done: Medical Reason" using "Medical Reason SNOMEDCT Value Set (2.16.840.1.113883.3.117.1.7.1.473)"
-
"Medication, Administered not done: Medical Reason" using "Medical Reason SNOMEDCT Value Set (2.16.840.1.113883.3.117.1.7.1.473)"
-
"Medication, Administered not done: Medical Reason" using "Medical Reason SNOMEDCT Value Set (2.16.840.1.113883.3.117.1.7.1.473)"
-
"Medication, Administered not done: Medical Reason" using "Medical Reason SNOMEDCT Value Set (2.16.840.1.113883.3.117.1.7.1.473)"
-
"Medication, Administered not done: Patient Refusal" using "Patient Refusal SNOMEDCT Value Set (2.16.840.1.113883.3.117.1.7.1.93)"
-
"Medication, Administered not done: Patient Refusal" using "Patient Refusal SNOMEDCT Value Set (2.16.840.1.113883.3.117.1.7.1.93)"
-
"Medication, Administered not done: Patient Refusal" using "Patient Refusal SNOMEDCT Value Set (2.16.840.1.113883.3.117.1.7.1.93)"
-
"Medication, Administered not done: Patient Refusal" using "Patient Refusal SNOMEDCT Value Set (2.16.840.1.113883.3.117.1.7.1.93)"
-
"Medication, Administered: Direct Thrombin Inhibitor" using "Direct Thrombin Inhibitor RXNORM Value Set (2.16.840.1.113883.3.117.1.7.1.205)"
-
"Medication, Administered: Glycoprotein IIb/IIIa Inhibitors" using "Glycoprotein IIb/IIIa Inhibitors RXNORM Value Set (2.16.840.1.113762.1.4.1045.41)"
-
"Medication, Administered: Injectable Factor Xa Inhibitor for VTE Prophylaxis" using "Injectable Factor Xa Inhibitor for VTE Prophylaxis RXNORM Value Set (2.16.840.1.113883.3.117.1.7.1.211)"
-
"Medication, Administered: Low Dose Unfractionated Heparin for VTE Prophylaxis" using "Low Dose Unfractionated Heparin for VTE Prophylaxis RXNORM Value Set (2.16.840.1.113762.1.4.1045.39)"
-
"Medication, Administered: Low Molecular Weight Heparin for VTE Prophylaxis" using "Low Molecular Weight Heparin for VTE Prophylaxis RXNORM Value Set (2.16.840.1.113883.3.117.1.7.1.219)"
-
"Medication, Administered: Oral Factor Xa Inhibitor for VTE Prophylaxis" using "Oral Factor Xa Inhibitor for VTE Prophylaxis RXNORM Value Set (2.16.840.1.113883.3.117.1.7.1.134)"
-
"Medication, Administered: Unfractionated Heparin" using "Unfractionated Heparin RXNORM Value Set (2.16.840.1.113883.3.117.1.7.1.218)"
-
"Medication, Administered: Warfarin" using "Warfarin RXNORM Value Set (2.16.840.1.113883.3.117.1.7.1.232)"
-
"Medication, Order not done: Medical Reason" using "Medical Reason SNOMEDCT Value Set (2.16.840.1.113883.3.117.1.7.1.473)"
-
"Medication, Order not done: Medical Reason" using "Medical Reason SNOMEDCT Value Set (2.16.840.1.113883.3.117.1.7.1.473)"
-
"Medication, Order not done: Medical Reason" using "Medical Reason SNOMEDCT Value Set (2.16.840.1.113883.3.117.1.7.1.473)"
-
"Medication, Order not done: Medical Reason" using "Medical Reason SNOMEDCT Value Set (2.16.840.1.113883.3.117.1.7.1.473)"
-
"Medication, Order not done: Patient Refusal" using "Patient Refusal SNOMEDCT Value Set (2.16.840.1.113883.3.117.1.7.1.93)"
-
"Medication, Order not done: Patient Refusal" using "Patient Refusal SNOMEDCT Value Set (2.16.840.1.113883.3.117.1.7.1.93)"
-
"Medication, Order not done: Patient Refusal" using "Patient Refusal SNOMEDCT Value Set (2.16.840.1.113883.3.117.1.7.1.93)"
-
"Medication, Order not done: Patient Refusal" using "Patient Refusal SNOMEDCT Value Set (2.16.840.1.113883.3.117.1.7.1.93)"
-
"Medication, Order: Injectable factor Xa inhibitor for VTE prophylaxis ingredient specific" using "Injectable factor Xa inhibitor for VTE prophylaxis ingredient specific RXNORM Value Set (2.16.840.1.113762.1.4.1021.11)"
-
"Medication, Order: Low Molecular Weight Heparin for VTE prophylaxis ingredient specific" using "Low Molecular Weight Heparin for VTE prophylaxis ingredient specific RXNORM Value Set (2.16.840.1.113762.1.4.1021.12)"
-
"Medication, Order: Unfractionated Heparin for VTE prophylaxis ingredient specific" using "Unfractionated Heparin for VTE prophylaxis ingredient specific RXNORM Value Set (2.16.840.1.113762.1.4.1021.13)"
-
"Medication, Order: Warfarin-only ingredient specific" using "Warfarin-only ingredient specific RXNORM Value Set (2.16.840.1.113762.1.4.1021.10)"
-
"Patient Characteristic Birthdate: birth date" using "birth date LOINC Value Set (2.16.840.1.113883.3.560.100.4)"
-
"Procedure, Performed: General Surgery" using "General Surgery Grouping Value Set (2.16.840.1.113883.3.117.1.7.1.255)"
-
"Procedure, Performed: General or Neuraxial Anesthesia" using "General or Neuraxial Anesthesia Grouping Value Set (2.16.840.1.113883.3.666.5.1743)"
-
"Procedure, Performed: Gynecological Surgery" using "Gynecological Surgery Grouping Value Set (2.16.840.1.113883.3.117.1.7.1.257)"
-
"Procedure, Performed: Hip Fracture Surgery" using "Hip Fracture Surgery Grouping Value Set (2.16.840.1.113883.3.117.1.7.1.258)"
-
"Procedure, Performed: Hip Replacement Surgery" using "Hip Replacement Surgery Grouping Value Set (2.16.840.1.113883.3.117.1.7.1.259)"
-
"Procedure, Performed: Intracranial Neurosurgery" using "Intracranial Neurosurgery Grouping Value Set (2.16.840.1.113883.3.117.1.7.1.260)"
-
"Procedure, Performed: Knee Replacement Surgery" using "Knee Replacement Surgery Grouping Value Set (2.16.840.1.113883.3.117.1.7.1.261)"
-
"Procedure, Performed: Urological Surgery" using "Urological Surgery Grouping Value Set (2.16.840.1.113883.3.117.1.7.1.272)"
-
"Risk Category Assessment: VTE Risk Assessment" using "VTE Risk Assessment LOINC Value Set (2.16.840.1.113883.3.117.1.7.1.357)"
-
Attribute: "Route: Subcutaneous route" using "Subcutaneous route SNOMEDCT Value Set (2.16.840.1.113883.3.117.1.7.1.223)"
-
Attribute: "Route: Intravenous route" using "Intravenous route SNOMEDCT Value Set (2.16.840.1.113883.3.117.1.7.1.222)"
-
Attribute: "Result: Low Risk" using "Low Risk SNOMEDCT Value Set (2.16.840.1.113883.3.117.1.7.1.400)"
-
Attribute: "Ordinality: Principal" using "Principal SNOMEDCT Value Set (2.16.840.1.113883.3.117.1.7.1.14)"
Diagnosis, Inactive: Venous Thromboembolism
Diagnosis, Active: Atrial Fibrillation/Flutter
Diagnosis, Inactive: Atrial Fibrillation/Flutter
Medication, Administered: Oral Factor Xa Inhibitor for VTE Prophylaxis
Diagnosis, Active: Obstetrics
Diagnosis, Active: Obstetrics VTE
Diagnosis, Active: Venous Thromboembolism
Patient Characteristic Birthdate: birth date
Medication, Administered: Unfractionated Heparin
Medication, Administered: Warfarin
Medication, Administered not done: Medical Reason
Medication, Administered not done: Patient Refusal
Device, Applied: Graduated compression stockings (GCS)
Device, Applied not done: Medical Reason
Device, Applied not done: Patient Refusal
Laboratory Test, Result: INR
Medication, Administered: Low Molecular Weight Heparin for VTE Prophylaxis
Medication, Administered not done: Medical Reason
Medication, Administered not done: Patient Refusal
Medication, Administered: Injectable Factor Xa Inhibitor for VTE Prophylaxis
Medication, Administered not done: Medical Reason
Medication, Administered not done: Patient Refusal
Device, Applied: Intermittent pneumatic compression devices (IPC)
Device, Applied not done: Medical Reason
Device, Applied not done: Patient Refusal
Device, Applied: Venous foot pumps (VFP)
Device, Applied not done: Medical Reason
Device, Applied not done: Patient Refusal
Risk Category Assessment: VTE Risk Assessment
ICU Admission or Transfer
Procedure, Performed: Intracranial Neurosurgery
Procedure, Performed: General Surgery
Procedure, Performed: Gynecological Surgery
Procedure, Performed: Urological Surgery
Procedure, Performed: Hip Replacement Surgery
Procedure, Performed: Knee Replacement Surgery
Procedure, Performed: Hip Fracture Surgery
Medication, Administered: Glycoprotein IIb/IIIa Inhibitors
Procedure, Performed: General or Neuraxial Anesthesia
Intervention, Order: Comfort Measures
Intervention, Performed: Comfort Measures
Medication, Administered: Low Dose Unfractionated Heparin for VTE Prophylaxis
Medication, Administered not done: Medical Reason
Medication, Administered not done: Patient Refusal
Device, Order: Intermittent pneumatic compression devices (IPC)
Device, Order not done: Medical Reason
Device, Order not done: Patient Refusal
Device, Order: Venous foot pumps (VFP)
Device, Order not done: Medical Reason
Device, Order not done: Patient Refusal
Device, Order: Graduated compression stockings (GCS)
Device, Order not done: Medical Reason
Device, Order not done: Patient Refusal
Emergency Department Visit
Medication, Administered: Direct Thrombin Inhibitor
Medication, Order: Injectable factor Xa inhibitor for VTE prophylaxis ingredient specific
Medication, Order not done: Medical Reason
Medication, Order not done: Patient Refusal
Medication, Order: Warfarin-only ingredient specific
Medication, Order not done: Medical Reason
Medication, Order not done: Patient Refusal
Medication, Order: Low Molecular Weight Heparin for VTE prophylaxis ingredient specific
Medication, Order not done: Medical Reason
Medication, Order not done: Patient Refusal
Medication, Order: Unfractionated Heparin for VTE prophylaxis ingredient specific
Medication, Order not done: Medical Reason
Medication, Order not done: Patient Refusal
Encounter Inpatient
Encounter, Performed: ICU Admission or Transfer
Encounter, Performed: Emergency Department Visit
Encounter, Performed: Encounter Inpatient
Reporting Stratification
- None
Supplemental Data Elements
-
"Patient Characteristic Ethnicity: Ethnicity" using "Ethnicity CDCREC Value Set (2.16.840.1.114222.4.11.837)"
-
"Patient Characteristic Payer: Payer" using "Payer SOP Value Set (2.16.840.1.114222.4.11.3591)"
-
"Patient Characteristic Race: Race" using "Race CDCREC Value Set (2.16.840.1.114222.4.11.836)"
-
"Patient Characteristic Sex: ONC Administrative Sex" using "ONC Administrative Sex AdministrativeSex Value Set (2.16.840.1.113762.1.4.1)"
Patient Characteristic Sex: ONC Administrative Sex
Patient Characteristic Race: Race
Patient Characteristic Ethnicity: Ethnicity
Patient Characteristic Payer: Payer