A trial of a new computer alert message to advise first-call physicians when their patients are at high risk of developing DVT (deep vein thrombosis) began on April 10, 2000. The computer system screens inpatients for a number of risk factors, such as age, bedrest orders, presence of cancer, post-operative status, and history of DVT or PE (pulmonary embolism). Only those patients who are at high risk and who have no DVT prophylaxis ordered, such as mechanical devices (eg, TED stockings and pneumoboots) and anticoagulants, are eligible.
Eligible patients are randomized to one of two groups-- intervention or control. The physicians of those in the intervention group receive a computer message that advises of DVT risk status and provides options to obtain more information or proceed to order entry to write orders, if appropriate for individual patients. Physicians of patients in the control group receive no notification.
If the trial is effective in reducing the incidence of DVT, then the computer alert will be sent routinely to physicians of all high-risk patients. Nurses still need to assess for DVT risk, since risk status for this complication will direct a number of independent nursing interventions, including providing patient/family education, encouraging ambulation, and maintaining fluid balance to prevent dehydration.
This study is a collaborative effort, involving members of several departments, including Medicine (Samuel Goldhaber, MD), Nursing (Lucy Feild, PhD, RN), and Information Systems (Samuel Wang, MD, PhD, and Marilyn Paterno) and data collection is expected to be completed in April 2001. For questions or comments, please contact Lucy Feild at ext. 5374.
—Lucy Field