Incidents of fatal blood clots have been on the rise for years, but this wasn’t always the case.
Americans are now in a health care catch-22. Prompt medical intervention is necessary when symptoms of blood clots develop, but a lack of appropriate care in hospitals is complicating the problem.
Behind Closed Doors
On a daily basis, trauma nurse Marion, who asked to be identified by her middle name, prepares patients for surgery and implements measures to reduce the risk of blood clots.“For surgery, almost everyone should have SCDs,” Marion said, referring to sequential compression devices.
SCDs are inflatable sleeves placed on the lower legs to help prevent deep vein thrombosis (DVT) by improving blood flow in a patient’s legs.
Marion said she thinks SCDs should be used more often in hospitals, but “It all depends on what doctors order for preventative measures.”
She’s noticed some doctors, to save time, don’t order an SCD when a surgical procedure is short. Marion says an SCD should be used for “every patient, every time.”
Dr. Emily Smith, a general practitioner and contributor at The Healthy Dart, said a combination of factors contribute to the high incidence of blood clot-related deaths in hospitals.
These include “inadequate awareness, suboptimal implementation of preventative measures, and challenges in identifying at-risk patients,” Dr. Smith told The Epoch Times.
Dr. Smith believes preventing blood clots from developing in hospital patients requires a “multi-faceted” approach including early mobility for patients, compression devices, the use of anticoagulants, and proper risk assessment screenings.
“Ensuring consistent implementation of these measures requires robust hospital policies, staff education, and patient engagement,” she said.
Former ICU nurse and aging life care professional Samantha Hainer agrees it takes a comprehensive approach.
“In my years as an ICU nurse, I’ve witnessed firsthand the increasing complexity of health care. Hospitals excel in providing immediate care, but the emphasis on prevention sometimes takes a backseat,” Ms. Hainer told The Epoch Times.
She said U.S. health care has evolved into a “multi-dimensional puzzle” where many factors feed into the problem. These range from genetic predispositions to stress, lifestyle choices, and co-morbidities.
“Imagine if our city invested solely in firefighting and not in fire prevention measures ... Similarly, in health care, we need to strike a balance between life-saving interventions and anticipatory, proactive prevention,” she said.
Ms. Hainer added that many blood clots go undiagnosed since the symptoms can be very subtle and public awareness of the issue remains limited. “I’ve even encountered patients who, despite the risks, refused to wear DVT compression stockings. It’s a stark reminder of the need for comprehensive education and awareness.”
Staff Shortages
Marion currently works in a large hospital in Houston, Texas, but she’s also worked as a trauma nurse in Minnesota, Connecticut, and Georgia.She said the biggest challenge facing blood clot prevention in U.S. hospitals is during the patient recovery phase.
In an operating room, the nurse-to-patient ratio is one-to-one. However, in the rest of the facility, it’s often a very different story.
“On the floor, the nurse ratio can be two to one, or three to one, But in med surg [medical surgical wards], the rate is like eight to one,” Marion said.
Medical surgical nursing focuses on caring for patients with existing health issues and also those preparing for or recovering from surgery.
Staff shortages are a critical element driving the spike in blood clot deaths in U.S. hospitals, according to Marion.
“It’s partly the nurse station ratio and the ability of a nurse actually to take care of their patient. When you have up to eight patients and so much charting [paperwork], where’s the time to do a proper check and assessment?” she said.
Physician’s assistant Carlos da Silva concurred, saying staffing is a big issue.
“Staffing shortages and understaffing in general in health care institutions play a role here. When there are too few nurses and doctors to go around, they don’t have the time to give every patient the one-on-one attention that they, arguably, deserve,” Mr. Silva told The Epoch Times
The United States has a health care worker shortage problem that is getting worse.
But the effects can already be felt in hospitals.
Marion said doctors don’t really get “in depth with patients” when they’re making the rounds. This leaves little time to analyze any subtle presentation of blood clot symptoms among patients.
Ms. Hainer said that while preventing blood clots isn’t a “one size fits all” solution, more face time between doctors, nurses, and patients is an indispensable part of it. “I’ve experienced the intricate challenges of blood clot prevention. Our health care system typically operates in a reactive mode, focusing on immediate interventions during crises.”
She compared the current state of hospital patient care to a city that “prioritizes fixing potholes over ensuring the roads are well-constructed.”
Mr. Silva said tools like pneumatic compression devices help improve circulation without any direct involvement from a medical professional, but they can’t replace critical, in-person analysis with a patient who may be starting to show symptoms of a blood clot.
“If nurses have a lighter patient load, they’re more able to help with exercises and treatments that can help to prevent clotting,” Mr. Silva said.
“The bottom line is that staff are more likely to identify and reverse these issues when they have more time to spend with each patient while they’re recovering.”
