ID

16042

Description

AAFP: CVT Outpatient Screening Criteria , Standardizes Admission Orders, Author: Robert M. Wiprud, MD The primary purpose of these Ordersets is to decrease unnecessary variability and to improve quality through standardized Admission Orders. Developed by the Scott & White Clinic at College Station, Texas. Copyright © 2006 American Academy of Family Physicians. Physicians may photocopy or adapt for use in their own practices; all other rights reserved. Wiprud RM. Providing consistent care with standardized admission orders. Fam Pract Manag. September 2006: 49-52 See http://www.aafp.org/fpm/2006/0900/p49.html This ODM Form includes the thirteenth section ("AAFP: CVT Outpatient Screening Criteria").

Link

http://www.aafp.org/fpm/2006/0900/p49.html

Keywords

Versions (1)
  1. 6/27/16 6/27/16 -
Uploaded on

June 27, 2016

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License

Creative Commons BY-NC 3.0
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AAFP: CVT Outpatient Screening Criteria

English

AAFP: CVT Outpatient Screening Criteria

1 forms  
Inclusion Criteria
Description

Inclusion Criteria

Acute, symptomatic, proximal or distal DVT documented by venogram/Doppler U/S
Description

Inclusion Criteria

Data type

boolean

Patient agrees to outpatient therapy
Description

Inclusion Criteria

Data type

boolean

Exclusion Criteria
Description

Exclusion Criteria

Current, active bleeding, active peptic or ulcer disease, congenital or acquired bleeding disorder or disease process in which, in the judgement of the physician, there may be an increased risk of bleeding (e.g. hepatic or renal insufficiency, recent surgery or stroke)
Description

Exclusion Criteria

Data type

boolean

Concurrent symptomatic pulmonary emboli
Description

Exclusion Criteria

Data type

boolean

Expected hospitalization greater than five days due to co-existing conditions
Description

Exclusion Criteria

Data type

boolean

Known hypercoagulability: familiar or acquired
Description

Exclusion Criteria

Data type

boolean

Pregnant or breast-feeding
Description

Exclusion Criteria

Data type

boolean

Uncontrolled hypertension
Description

Exclusion Criteria

Data type

boolean

Extensive iliofemoral DVT
Description

Exclusion Criteria

Data type

boolean

Likelihood of non-compliance due to cognitive limitations, alcohol/drug abuse, dementia, psychiatric disorders, etc.
Description

Exclusion Criteria

Data type

boolean

if yes, please describe
Description

Exclusion Criteria - Likelihoof of non-compliance

Data type

text

Decision
Description

Decision

Patient meets criteria for outpatient Lovenox therapy. Begin patient education.
Description

Decision

Data type

boolean

Lovenox self-administration and anticoagulation precautions.
Description

Decision

Data type

boolean

Patient does not qualify for outpatient Lovenox therapy.
Description

Decision

Data type

boolean

Signature
Description

Signature

Data type

text

Print Name
Description

Print Name

Data type

text

Date and Time
Description

Date and Time

Data type

datetime

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Similar models

AAFP: CVT Outpatient Screening Criteria

1 forms
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Inclusion Criteria
Inclusion Criteria
Item
Acute, symptomatic, proximal or distal DVT documented by venogram/Doppler U/S
boolean
Inclusion Criteria
Item
Patient agrees to outpatient therapy
boolean
Item Group
Exclusion Criteria
Exclusion Criteria
Item
Current, active bleeding, active peptic or ulcer disease, congenital or acquired bleeding disorder or disease process in which, in the judgement of the physician, there may be an increased risk of bleeding (e.g. hepatic or renal insufficiency, recent surgery or stroke)
boolean
Exclusion Criteria
Item
Concurrent symptomatic pulmonary emboli
boolean
Exclusion Criteria
Item
Expected hospitalization greater than five days due to co-existing conditions
boolean
Exclusion Criteria
Item
Known hypercoagulability: familiar or acquired
boolean
Exclusion Criteria
Item
Pregnant or breast-feeding
boolean
Exclusion Criteria
Item
Uncontrolled hypertension
boolean
Exclusion Criteria
Item
Extensive iliofemoral DVT
boolean
Exclusion Criteria
Item
Likelihood of non-compliance due to cognitive limitations, alcohol/drug abuse, dementia, psychiatric disorders, etc.
boolean
Exclusion Criteria - Likelihoof of non-compliance
Item
if yes, please describe
text
Item Group
Decision
Decision
Item
Patient meets criteria for outpatient Lovenox therapy. Begin patient education.
boolean
Decision
Item
Lovenox self-administration and anticoagulation precautions.
boolean
Decision
Item
Patient does not qualify for outpatient Lovenox therapy.
boolean
Signature
Item
Signature
text
Print Name
Item
Print Name
text
Date and Time
Item
Date and Time
datetime
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