SHM Converge Scientific Abstract ePoster Gallery-Standardizing Postoperative DVT Prophylaxis After Hip Surgery

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This quality improvement project evaluated whether standardizing post-operative venous thromboembolism (VTE) prophylaxis after hip fracture surgery would improve guideline-based care and reduce complications. Hip and knee surgeries carry the highest orthopedic VTE risk, especially in the first 10 days after surgery, with risk persisting up to 3 months. Current AAOS guidance recommends pharmacologic prophylaxis, preferably rivaroxaban or weight-based low molecular weight heparin, for at least 10–14 days and up to 35 days, while aspirin alone is not recommended.<br /><br />The team reviewed baseline practice in 89 patients and found that 85% were discharged with either no VTE prophylaxis or aspirin only, and 14% received a DOAC. To improve compliance, an order set was created that discharged post-operative patients on rivaroxaban 10 mg daily for 21 days. The intervention was then assessed in 43 patients with femoral fractures undergoing surgical fixation between August and November 2021. Charts were reviewed for three months after admission to identify any VTE or bleeding-related readmissions.<br /><br />After implementation of the order set, 67% of patients were discharged with appropriate VTE prophylaxis. At three months, there were zero readmissions for DVT or gastrointestinal bleeding. The authors concluded that implementing a standardized order set increased adherence to guideline-directed prophylaxis after hip surgery without increasing bleeding complications. They noted that the project was limited by a small sample size and single-institution design, but suggested that similar order-set interventions could be adopted in other orthopedic settings.

Asset Subtitle

Angelica Thapa

Meta Tag

Author List Angelica Thapa, Brandon Turnage, William Ford

Category Research

Concept Postoperative Venous Thromboembolism Risk

Concept Pharmacologic Venous Thromboembolism Prophylaxis

Concept Hip Surgery

Concept Knee Surgery

Concept Hip Replacement

Distinguished Non-Finalist

Presenter Organization BMHCC

Presenting Author Angelica Thapa

Track Quality Improvement

Keywords

hip fracture surgery

venous thromboembolism prophylaxis

orthopedic quality improvement

rivaroxaban

post-operative care

guideline adherence

low molecular weight heparin

deep vein thrombosis

bleeding complications

order set standardization

Postoperative Venous Thromboembolism Risk

Pharmacologic Venous Thromboembolism Prophylaxis

Hip Surgery

Knee Surgery

Hip Replacement