Venous thromboembolism (VTE) is a major health problem that affects about 900 000 patients in the United States annually and results in an estimated 300 000 deaths. Critically ill patients who receive VTE prophylaxis have a significantly lower risk of death than do those who do not receive VTE prophylaxis. In a recent study, the incidence of deep vein thrombosis (DVT) in critically ill patients without VTE prophylaxis was 11%.

Assess all patients upon admission for risk factors for VTE and bleeding and anticipate orders for VTE prophylaxis depending on the risk assessment.

Consider VTE prophylaxis for the following patients:

Review each patient’s current VTE risk factors daily.

Maximize the patient’s mobility whenever possible. Mobilizing patients does not eliminate the need for chemical prophylaxis as ambulatory patients may still be an increased risk for VTE.

Ensure mechanical prophylaxis devices are fitted properly and in use at all times except when...

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