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Related Concept Videos

Venous Thrombosis III: Interprofessional Care01:29

Venous Thrombosis III: Interprofessional Care

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Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
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Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies01:20

Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies

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The key difference between Superficial Vein Thrombosis (SVT) and Deep Vein Thrombosis (DVT) lies in their location and severity.Clinical ManifestationsSVT typically presents with localized pain, tenderness, and redness along the course of a superficial vein, often accompanied by a palpable, cord-like structure under the skin. This condition is usually less dangerous than DVT but can be uncomfortable and may lead to complications such as cellulitis or, rarely, a clot extension into the deep...
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Venous Thrombosis IV: Nursing Management01:30

Venous Thrombosis IV: Nursing Management

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Nursing management begins with a thorough assessment of the patient's health history. Key factors include trauma to veins, peripherally inserted central catheters, varicose veins, recent pregnancy or childbirth, surgery, bacteremia, prolonged bed rest, atrial fibrillation, COPD, heart failure, cancer, coagulation disorders, myocardial infarction, spinal cord injury, stroke, prolonged travel, recent bone fractures, and dehydration. Review medication intake, particularly oral contraceptives,...
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Venous Thrombosis I: Introduction01:30

Venous Thrombosis I: Introduction

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Venous thrombosis, the most common disorder of the veins, involves the formation of a thrombus or blood clot associated with vein inflammation. It can be classified as either superficial vein thrombosis or deep vein thrombosis.Superficial Vein Thrombosis: This involves the formation of a thrombus in a superficial vein, usually the greater or lesser saphenous vein. Though less severe than deep vein thrombosis (DVT), SVT can lead to complications if untreated.Deep Vein Thrombosis (DVT): This...
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Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care01:29

Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care

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Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
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Pulmonary Embolism III: Nursing Management01:27

Pulmonary Embolism III: Nursing Management

311
A pulmonary embolism occurs when a thrombus, amniotic fluid, tumor tissue, fat, or air embolus blocks one or more pulmonary arteries. Effective nursing management and patient education are crucial for improving outcomes and preventing recurrence.Nursing management starts with obtaining a comprehensive patient history, particularly noting any history of deep vein thrombosis (DVT). Assess for clinical manifestations, including dyspnea, chest pain, crackles, heart murmurs, and signs of right-sided...
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Delayed Venous Thromboembolism Diagnosis and Mortality Risk.

Min-Jeoung Kang1,2, Richard Schreiber3, Veysel Karani Baris1,4

  • 1Department of Medicine, Division of General Internal Medicine, Brigham and Women's Hospital, Boston, Massachusetts.

JAMA Network Open
|September 26, 2025
PubMed
Summary
This summary is machine-generated.

High rates of diagnostic delay in venous thromboembolism (VTE) were observed, with delayed diagnosis significantly increasing mortality risk. The DOVE eCQM tool can aid quality improvement efforts for VTE diagnosis.

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Area of Science:

  • Medical Informatics
  • Clinical Quality Measurement
  • Public Health

Background:

  • Nonspecific symptoms of venous thromboembolism (VTE) complicate early detection.
  • Automated tools for monitoring VTE diagnostic delays are currently lacking.
  • Timely VTE diagnosis is critical for patient outcomes.

Purpose of the Study:

  • To evaluate diagnostic delay of VTE (DOVE) rates across two healthcare systems with different EHRs.
  • To categorize the reasons for missed VTE diagnoses.
  • To assess the association between diagnostic delays and 30-day all-cause mortality.

Main Methods:

  • Retrospective analysis of electronic health record (EHR) data from Mass General Brigham (MGB) and Penn State Health (PSH).
  • Development and application of an electronic clinical quality measure (eCQM) to quantify DOVE.
  • Comparison of 30-day all-cause mortality between timely (≤24 hours) and delayed (>24 hours) VTE diagnoses.

Main Results:

  • High DOVE rates were observed: 79.43% (MGB) and 82.38% (PSH) using a >24-hour threshold.
  • Practitioner-related factors were the most common cause of diagnostic delays.
  • Delayed VTE diagnosis was associated with increased 30-day all-cause mortality (RR 3.31 at MGB; RR 1.28 at PSH).

Conclusions:

  • Consistently high DOVE rates indicate a significant challenge in timely VTE diagnosis.
  • The DOVE eCQM tool is valuable for identifying and addressing diagnostic delays.
  • Implementation of the DOVE eCQM can support quality improvement initiatives at multiple healthcare levels.