Things to discuss in a nursing huddle to prevent VTE
Featured expert
Melissa Schmidt
Clinical Nurse Specialist for Neurosciences
Barnes-Jewish Hospital,
Washington University Medical Center
An interview with Melissa Schmidt, Clinical Nurse Specialist for Neurosciences at Missouri's largest hospital.
Each year 350,000 to 600,000 Americans are affected by venous thromboembolism (VTE), and they primarily consistent of those who are hospitalized or were recently hospitalized. Over a 10-year period, about 40 percent of patients have recurrent episodes of VTE.
Barnes-Jewish Hospital at Washington University Medical Center, Missouri's largest hospital, is fighting VTE by training healthcare providers, including clinical nurse specialists, in actionable VTE prevention strategies according to Clinical Nurse Specialist for Neurosciences, Melissa Schmidt.
The nursing huddle is “the best way to share timely, need-to-know information," according to Schmidt.
- Nursing huddles last five minutes and are held twice a day.
- Only the most important information is shared.
- Huddle topics are documented and available for review at the nurses' station for those who weren't present.
To keep information fresh and relevant, each topic is only discussed for one week at a time.
Top VTE nursing huddle topics
Schmidt recommended prioritizing the following topics for VTE discussion in the nursing huddle:
1. The process for what to do if a patient refuses chemical prophylaxis
2. Educate staff on treatment with intermittent pneumatic compression (IPC) devices
3. Share strategies to get the patient to wear IPC devices 80 percent of the time
“The best strategy for VTE prevention is using compression devices with a monitor that displays the percentage of the time the patient has been wearing the pneumatic compression device," Schmidt said. This allows clinical nurse specialists to know patient compliance in real time. The assistant nurse manager can then note and track whether a patient has worn the IPC devices 80 percent of the time.
Patient compliance needs to be a team effort between clinical nurse specialists and other hospital staff. This includes understanding why patients are unable to meet the 80 percent goal.
For instance, Schmidt explained, “If a patient travels to physical or occupational therapy, they may not be permitted to wear their IPC device during transport and treatment. Clinical nurse specialists should collaborate with other providers to ensure the pneumatic compression device is put back on the patient after services."
When a patient falls short of the 80 percent goal, clinical nurse specialists must work with the patient to address barriers to compliance, Schmidt said. Information on compliance rates for all patients is circulated within the unit every other month.
