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Quality Improvement  
Exchange Information Implementation Guide Professional Development Resource Room Project Team Main Resource Room Home Venous Thromboembolism Resource Room

Ordersets / Protocols

Carillion Medical Center - VTE Prophylaxis Order Form

This VTE Protocol for Adult inpatients from Carilion Medical Center a non-profit community health center is courtesy of James B. Franko MD, FACP. Available in paper based format the tool was implemented in February of 2004. The purpose of the tool is to list risk factors for VTE, define exclusion criteria for VTE prophylaxis, and list treatment options for VTE prophylaxis.

This form evolved into a standing order for LMWH triggered when nurses identified risk factors during the admission intake assessment Formulary: two LMWHs (Dalteparin and Enoxaparin)

Learn more about the Carillion VTE Prophylaxis Order Form

View the Carillion Medical Center Venous Thromboembolic (VTE) Prophylaxis Order Form

University of California, San Francisco Medical Center - Adult Venous Thromboembolism Prophylaxis Order Form

This Adult Venous Thromboembolism Prophylaxis Order Form courtesy of Tom Bookwalter, PharmD was authored by Steve Kayser, PharmD, Lisa Tong, PharmD. This tool available in paper based format was implemented in August of 2003 at the University of California, San Francisco Medical Center, a 500 bed teaching hospital. The goal of the tool is to increase the number of patients receiving appropriate prophylaxis.

Learn more about the Adult Venous Thromboembolism Prophylaxis Order Form

View the Adult Venous Thromboembolism Prophylaxis Order Form

Idaho State University VTE Protocol

The Idaho State University VTE Protocol for Adult inpatients is in paper based format. Used for all new patients admitted, this risk assessment supports decision making for any admission orders.

View the Idaho State University Protocol

Caritas Northwood Hospital Adult DVT Prophylaxis Physician Order Sheet

This DVT Prophylaxis Physician Order Sheet is a standing order for all adult inpatients admitted.

View the Caritas DVT Prophylaxis Order Sheet




Venous Thromboembolism Resource Room Project Team
This resource room is sponsored in part by a non-educational sponsorship from sanofi-aventis US, LLC

The Venous Thromboembolism (VTE) Resource Room is an online resource for visitors to the Society of Hospital Medicine’s website. All content and links have been reviewed by the VTE Resource Room Project Team, however the Society of Hospital Medicine does not exercise any editorial control over content associated with the external links that have been made available via this website.

The contributions of Dr. Maynard and his UCSD collaborators in the development of the SHM VTE Prevention Resource Room and the VTE Prevention Implementation Guide were supported by grant number 1U18HS015826-01 from the Agency for Healthcare Research and Quality (AHRQ). The contents of this product are solely the responsibility of Dr. Maynard and the SHM VTE Resource Room team, and do not necessarily represent the official view of or imply endorsement by AHRQ or the U.S. Department of Health and Human Services.

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