The
Joint Commission Core Measures
Check
List Card
|
AMI |
CHF |
Pneumonia |
|
Indicators
During Admission √ ASA within 24 hrs √ Beta Blockers within 24 hrs √ ACE Inhibitor/ARB √ Smoking Cessation
advised/counseling |
Indicators
During Admission
√ Document LVEF √ ACE Inhibitor/ARB (If LVEF <40%) √ Smoking Cessation
advised/counseling |
Indicators
During Admission
√ First dose of antibiotic within 4 hrs from triage √ Oxygen assessment within 24 hrs √ Blood cultures done prior to antibiotics √ Appropriate antibiotic selection √ Smoking Cessation
advised/counseling |
|
Indicators
at Time of Discharge √ ASA √ Beta Blockers √ ACE Inhibitor/ARB √ Smoking Cessation
advised/counseling |
Indicators
at Time of Discharge √ ACE Inhibitors/ARB (If LVEF <40%) √ Smoking Cessation
advised/counseling √ Discharge Instructions: (all 6 must be documented) ·
Activity ·
Diet ·
Follow-up appointments ·
Medication instructions ·
Weight monitoring ·
What to do if symptoms worsen |
Indicators
at Time of Discharge √ Pneumococcal screen/vaccination √ Influenza screen/vaccination √ Smoking Cessation
advised/counseling |
Please document
contraindication or reason for omission for any of the above medications.
DVT Prophylaxis
|
Low-risk factors (Prophylaxis is generally indicated if TWO OR MORE of these are
present) |
Moderate-risk factors (Prophylaxis is generally indicated if ANY of these are present) |
Major-risk factors (Prophylaxis is generally indicated if ANY of these are present) |
|
·
Minor surgery (less than 45 minutes) |
·
Age 60-74 years |
·
Hip/Knee arthroplasty |
|
·
Oral contraception or hormone replacement therapy |
·
Factor
V Leiden/Activated protein C resistance |
·
Multiple trauma within last 30
days (nonambulatory patients) |
|
·
Age
41 - 59 years |
·
History or family history of
thrombosis |
·
Hip/pelvic fracture in last 30
days |
|
·
Recent (less than 30 days)
major surgery |
·
Current or history of malignancy |
·
Acute spinal cord injury within
30 days |
|
·
Varicose veins |
·
Major surgery more than 45 minutes |
·
Long bone fractures |
|
·
Inflammatory
bowel disease |
·
Patient confined to bed more than 72
hours |
|
|
·
Obesity (BMI more than 30) |
·
Acute
or decompensated heart failure |
|
|
·
Acute myocardial infarction |
·
Nonhemorrhagic
stroke within last 30 days |
|
|
·
Pregnancy
or postpartum within 30 days |
·
Congenital or acquired thrombophilia |
|
|
·
Compensated
heart failure |
|
|
|
·
Serious
lung disease/ current smoker |
|
|
|
·
Nephrotic
syndrome |
|
|
|
·
Laparoscopic
surgery |
|
|
|
·
Elective
spinal surgery |
|
|
DVT Prophylaxis
Contraindications
|
Absolute: If any box is checked, pharmacologic
anticoagulation is not recommended; use mechanical prophylaxis if indicated |
Relative: Balance risks and benefits before
determining best option for individual patients |
||
|
·
History of heparin-induced
thrombocytopenia (HIT) ·
Epidural
or spinal tap within last 12 hours ·
Uncontrolled
hypertension* (SBP >200, DBP
>120, crisis) *MD,
please reassess in 24 hours |
·
Coagulopathy
(PT >18 seconds) ·
Patient is currently Anticoagulated ·
Active bleeding ·
Intracranial bleed/neoplasm/monitor |
·
History
of cerebral hemorrhage ·
History
of GI or GU bleed in last 6 months ·
Solid organ laceration ·
Intracranial
or intraocular surgery within last
14 days ·
Spinal injury/surgery |
·
Thrombocytopenia
(platelet <
50,000/mL) ·
Proliferative
retinopathy ·
Renal failure on dialysis ·
Biopsy site or vascular device
inaccessible to compression ·
Epidural catheter removal within 4 hours |