Evidenced based patient safety project/Nursing Protocol and Procedures Nursing P
Evidenced based patient safety project/Nursing Protocol and Procedures.
Nursing Protocol and Procedures
Name: MCD Protocol
Scope: Organization-wide Page 1 of 12
Patient care is revised to meet the individual patient needs.
DISCLAIMER: This policy was developed solely for the use of Childrens Hospital of Chicago Medical Center and
its affiliates (Medical Center). The information contained herein shall not be relied upon by individuals or
entities outside Medical Center for accuracy timeliness or any other purpose.
PURPOSE:
To outline the nursing management for the prevention of deep vein thrombosis and venous
thromboembolism in patients who are thirteen years (13) of age or older.
DEFINITIONS:
Thromboembolism: Blood clot in an artery or vein is known as thromboembolism.
Deep Vein Thrombosis (DVT): Development of thrombosis in one of the deep veins of the
extremities frequently the iliac or femoral veins or major upper extremity veins. These clots can
break off from the vein travel through the heart and lodge in the arteries of the lungs causing a
potentially fatal pulmonary embolism.
Pulmonary Embolism (PE): A thrombus that breaks free from a vein travels through the
veins reaches the lungs and lodges in a major or minor pulmonary vessel. A pulmonary
embolism is a potentially fatal condition that may cause death within minutes to hours.
Mechanical Compression device (MCD): A mechanical device that is used for pneumatic
compression applied via a cuff that inflates and deflates uniformly. The cuff may be applied to
the extremity.
Thrombophlebitis: The formation of a venous clot accompanied by inflammation of the vein
wall. This may be the result of trauma to the vessel wall hypercoagulability of the blood or
infection. Intra or post-operative venous stasis prolonged sitting standing or immobilization or
a long period of IV catheterization (eg. PICC line) may also cause thrombophlebitis.
Venous Thromboembolism (VTE): A condition including DVT and PE.
Venous thrombosis: A condition that occurs when a clot forms within a vein without
inflammation.
Nursing Protocol and Procedures
Name: MCD Protocol
Scope: Organization-wide Page 2 of 12
Patient care is revised to meet the individual patient needs.
DISCLAIMER: This policy was developed solely for the use of Childrens Hospital of Chicago Medical Center and
its affiliates (Medical Center). The information contained herein shall not be relied upon by individuals or
entities outside Medical Center for accuracy timeliness or any other purpose.
Supportive Data
The prevalence of blood clots in pediatric patients is on the rise. Nearly 80% of blood clots in
this population occur in the hospitalized setting and about 1 in 200 hospitalized pediatric patients
develop blood clots. Considering the long-term morbidity of blood clots prevention is vital. It is
recommended that every child thirteen (13) years of age or older be assessed for the need of
MCD sleeves. If the patient is under the age of thirteen (13) application of MCD sleeves and
devices are per Physician/APN discretion only.
EQUIPMENT LIST:
Mechanical Compression Sleeves
Mechanical Compression Device
SECTION TITLES:
A. Pre-Procedural Patients
B. Intra-Procedural Patients
C. Post-Procedural Patients
D. Non-Procedural Patients
Nursing Protocol and Procedures
Name: MCD Protocol
Scope: Organization-wide Page 3 of 12
Patient care is revised to meet the individual patient needs.
DISCLAIMER: This policy was developed solely for the use of Childrens Hospital of Chicago Medical Center and
its affiliates (Medical Center). The information contained herein shall not be relied upon by individuals or
entities outside Medical Center for accuracy timeliness or any other purpose.
DVT Risk Factor Assessment Sheet
Directions: For patients 13 years of age or older review the risk factors listed below.
Total the number of Major and Minor Risk factors. YES = 1 point NO = 0 point
Major Risk Factor of 1 point or more = Place MCD Sleeves on the patient
Minor Risk Factor of 3 points or more = Place MCD Sleeves on the patient
Possible Risk Factors Yes / No
Major Risk Factors
Personal history of blood clot Yes / No
Personal history of known thrombophilia (clotting disorder) Yes / No
History of blood clots in immediate family (mother father brother sisters aunts uncles grandparents) Yes / No
Immobilization (bed ridden/wheel chair bound) for at least 72 hours prior to or following the
admission/procedure
Yes / No
Major orthopedic fractures: hip and/or pelvis Yes / No
Pregnancy or Post-Partum Period Yes / No
Morbid obesity (BMI >40 kg/m2) Yes / No
History of Anticoagulant Therapy Yes / No
TOTAL NUMBER OF MAJOR RISK FACTORS ________points
Minor Risk Factors
General Anesthesia Yes / No
Patient on Birth Control Pills / Hormone Therapy Yes / No
Scheduled Surgery time > 1hour Yes / No
Orthopedic fractures: Lower Extremity Yes / No
Disease etiology predisposing to DVT:
Crohns Disease/Ulcerative Colitis
Nephrotic Syndrome
SLE (Lupus)
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