Audit of VTE prophylaxis risk assessment and prescribing for general medical inpatients

Abstract

Venous thromboembolism is a significant cause of morbidity and mortality
amongst hospitalised patients. The aim was to review the current level of
completeness of venous thromboembolism (VTE) prophylaxis risk assessment
documentation at Surrey and Sussex Healthcare NHS Trust. The
VTE prophylaxis risk assessment form is provided on Cerner and all doctors
are prompted to complete this when opening a patient record. The risk
assessment proforma ensures that all patients who are assessed as either at
moderate or high risk of VTE during their admission receive pharmacological
VTE prophylaxis or if contraindicated mechanical prophylaxis. Using
the Trusts thromboprophylaxis guideline, six standards were defined. The
target for each standard is set at 100% and complies with national audit
standards for preventing hospital acquired VTE and PE.

Results are shown further in the text:
Ninety three per cent of admissions had documented assessments on
admission to hospital. 0.03% had VTE risk reassessed within 24 h- and

some of these patients would have gone to other wards first, 12.5% had
24 h reassessment documented which did not meet national targets.
Limitations faced included: limited timeframe of data collection, small
sample size and prophylaxis could have been prescribed, but the clinician
had not recorded the assessment on the electronic record (Cerner).
These findings have been presented to our local general internal medicine
department. We plan to reaudit VTE compliance on another GIM ward.
We expect findings to be similar; therefore we plan to implement a change
to improve compliance rates to the national standard. We will then reaudit
within 6 months to see if we have improved. I’m looking forward to
the results!