VTE Prophylaxis Assessment Checklist
Assess all hospitalized patients for venous thromboembolism risk and implement appropriate prophylaxis measures per Joint Commission requirements.
- Industry: Healthcare
- Frequency: Admission and ongoing
- Estimated Time: 5-10 minutes
- Role: Physician/Nurse
- Total Items: 29
- Compliance: Joint Commission VTE Core Measures, ACCP Guidelines, CMS VTE Prevention
VTE Risk Factors
Identify patient risk factors
- Prior VTE history?
- Active cancer or chemotherapy?
- Major surgery within 3 months?
- Reduced mobility/bed rest?
- Known hypercoagulable state?
- Age over 60?
- Obesity (BMI > 30)?
- Pregnancy or postpartum?
- Central venous catheter?
Bleeding Risk/Contraindications
Assess bleeding risk
- Active bleeding?
- Known bleeding disorder?
- Recent major hemorrhage?
- Severe thrombocytopenia (<50K)?
- Epidural catheter in place?
- Recent intracranial hemorrhage?
Prophylaxis Selection
Choose appropriate prophylaxis
- Pharmacologic prophylaxis ordered?
- Appropriate drug selected (LMWH, UFH, fondaparinux)?
- Mechanical prophylaxis ordered (SCDs, IPC)?
- If no prophylaxis, contraindication documented?
Implementation Verification
Verify prophylaxis given
- VTE prophylaxis medication administered?
- Mechanical devices applied and functioning?
- Early ambulation encouraged?
Patient Education
VTE education provided
- Patient educated about VTE risks?
- Signs/symptoms of DVT/PE discussed?
- Discharge VTE prevention instructions given?
Infection Prevention & Control
Infection control per CDC/Joint Commission
- Hand hygiene compliance observed?
- Isolation precautions followed correctly?
- Sharps containers not overfilled?
- Appropriate PPE available and used?
Related Healthcare Checklists
- Patient Handoff SBAR Communication Checklist
- Patient Restraint Assessment & Monitoring Checklist
- Pressure Ulcer/Injury Prevention Checklist
- Patient Fall Risk Hourly Rounding Checklist
- Medication Administration Safety Checklist
- Blood Product Transfusion Safety Checklist
- Discharge Planning & Readiness Checklist
- Nursing Shift Assessment Checklist