Clinical Tip, Patient Safety, VTE

5 Steps to Keep New Mothers Safer from VTE (blood clot) development

By Lynn Razzano, RN, MSN, ONCC

Following delivery, mothers are at risk for developing blood clots much longer than previously thought – twice as long – according to research presented February 13, 2014 at the American Stroke Association’s International Stroke Conference.

It was a well-known and established fact that the risk of venous thromboembolism (VTE or commonly referred to as “blood clots”) remains high for one month after giving birth. However, this research significantly extends the at risk time frame – the VTE risk window post delivery and the identification of level of increased risk for the following duration weeks:

  • Weeks 0-6: 10.8 times higher
  • Weeks 7-12: 2.2 times higher
  • Weeks 13-18: 1.4 times higher

This new research suggests five steps that new mothers and their doctors can do:

  1. New mothers should be provided education on this new VTE risk window extension of 12 weeks post delivery. The patient should be provided this information to the nurse when discharge is anticipated. In addition, the information should be sent to her primary care provider or for the next scheduled follow up appointment.
  2. In accordance with the newly release OB VTE Safety Recommendations, the appropriate prophylatic regimen should be discussed with the patient during discharge, which discussion should include this extended VTE risk window discussion and compliance with physician-prescribed recommendations, both pharmacological prophylaxis and compression devices with appropriate instructions for “wear time” discharge.
  3. The new mother’s physician should obtain the appropriate order for home mechanical prophylaxis and initiate a DME (durable medical equipment) referral to provide to patient on arrival to home.
  4. The post discharge call by the discharging clinician should occur and validate the patient has received the compression device, knows how to apply and the necessary wear time. In addition the patient should be instructed in proper skin inspection and removal of the device for all ambulation periods.

The new mother should verbalize “read back” knowledge of all post discharge instructions. Her significant other or caregivers should be provided this information as well.

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