Implementation of a national guideline on prophylaxis of venous thromboembolism: a survey of acute services in Scotland. Thromboembolism Prevention Evaluation Study Group.
BACKGROUND
Deep vein thrombosis (DVT) and pulmonary embolism (PE) are major complications for hospital patients in developed countries. In 1995, the Scottish Intercollegiate Guidelines Network (SIGN) published an evidence-based guideline to encourage the appropriate use of prophylaxis for DVT among hospitalised patients at risk. The guideline was widely distributed within the NHS in Scotland; however, it is not clear what actions trusts have taken to implement it.


OBJECTIVE
To investigate the type and extent of DVT guideline implementation activities in acute trusts in Scotland.


METHODS
A semi-structured telephone interview with senior clinical audit staff in those trusts with acute services in Scotland.


RESULTS
Twenty-nine of the 30 trusts approached participated in the survey (97%). A range of responses to the guideline were reported, including development of local protocols (n = 20), audit of DVT prophylaxis (n = 19), patient specific reminders (n = 13) and provision of a specialist DVT adviser (n = 3). Overall, 25 of the trusts had undertaken guideline development and dissemination activities, and 17 were involved in more active guideline implementation strategies.


CONCLUSIONS
The majority of acute trusts in Scotland have responded to the SIGN guideline, usually through the development of local protocols. Strategies to implement the guideline or local protocol are less common. Further guidance is needed on this in the next edition of the guideline.
Walker
A
A
Health Services Research Unit, University of Aberdeen, Department of Public Health, Drew Kay Wing, Polwarth Building, Foresterhill, Aberdeen AB25 2ZD.
Campbell
S
S
Grimshaw
J
J
D002985:Clinical Protocols; D019317:Evidence-Based Medicine; D019983:Guideline Adherence; D006779:Hospitals, Public / Q000592:standards*; D006801:Humans; D033181:Information Dissemination; D007407:Interviews as Topic; D017410:Practice Guidelines as Topic; D012606:Scotland; D020246:Venous Thrombosis / Q000517:prevention & control*