Abstract
Background and aims
Venous thromboembolism (VTE) is a potential source of morbidity and mortality in surgical in-patients. A number of guidelines exist that advise on prophylactic measures. We aimed to assess VTE prophylaxis prescribing practices and compliance with a kardex-based risk assessment tool in a general surgery population.
Methods
Data on general surgery in-patients were collected on two separate wards on two separate days. Drug kardexes were assessed for VTE prophylaxis measures and use of the risk assessment tool. NICE and SIGN guidelines were adopted as a gold standard. The audit results and information on the risk assessment tool were presented as an educational intervention at two separate departmental teaching sessions. A re-audit was completed after 3 months.
Results
In Audit A, 74 patients were assessed. 70% were emergency admissions. The risk assessment tool was completed in 2.7%. 75 and 97% of patients were correctly prescribed anti-embolic stockings (AES) and low-molecular weight heparin (LMWH), respectively. 30 patients were included in Audit B, 56% of whom were emergency admissions. 66% had a risk assessment performed, a statistically significant improvement (p < 0.0001). Rates of LMWH prescribing were similar (96%), but AES prescribing was lower (36%).
Conclusion
Rates of LMWH prescribing are high in this general surgical population, although AES prescribing rates vary. Use of the VTE risk assessment tool increased following the initial audit and intervention.
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References
The House of Commons Health Committee (2005) The prevention of venous thromboembolism in hospitalised patients. The Stationery Office Limited, London
Geerts WH, Pineo GF, Heit JA et al (2004) Prevention of venous thromboembolism: The Seventh ACCP Conference on antithrombotic and thrombolytic therapy. Chest 126(3 suppl):338s–400s
National Institute for Health and Clinical Excellence (NICE) (2010) Venous thromboembolism: reducing the risk for patients in hospital. NICE, London. https://www.nice.org.uk/guidance/cg92. Accessed 01 May 2016 (updated 2015)
Scottish Intercollegiate Guideline Network (SIGN) (2010) Guideline122: prevention and management of venous thromboembolism. Edinburgh, Scotland. https://www.sign.ac.uk/pdf/sign122.pdf Accessed 01 May 2016 (updated 2014)
Hospital Thrombosis Group, Cork University Hospital (2015) Thromboprophylaxis guidelines for adult patients. http://www.emed.ie/Haematology/_img/Haem-TP_CUH_Guidelines_2015.pdf. Accessed 01 May 2016
NHS UK (2016) Venous thromboembolism (VTE) risk assessment data collection Quarter 3 2015/16 (October–December 2015). https://www.england.nhs.uk/statistics/2016. Accessed 01 May 2016
Cohen AT, Tapson VF, Bergmann JF et al (2008) ENDORSE Investigators. Venous thromboembolism risk and prophylaxis in the acute hospital care setting (ENDORSE study): a multinational cross-sectional study. Lancet 2(371):387–394
Murphy D, O’Connell O, Liston R et al (2012) Venous thromboembolism risk and prophylaxis in the acute hospital care setting: the Irish results of the ENDORSE study. Ir Med J 105(5):140–143
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David McGoldrick declares that he has no conflict of interest. H Paul Redmond declares that he has no conflict of interest.
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McGoldrick, D.M., Redmond, H.P. Venous thromboembolism prophylaxis risk assessment in a general surgery cohort: a closed-loop audit. Ir J Med Sci 186, 743–745 (2017). https://doi.org/10.1007/s11845-016-1529-0
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DOI: https://doi.org/10.1007/s11845-016-1529-0