Venous thromboembolism prophylaxis in a South Australian teaching hospital.
BACKGROUND
Venous thromboembolism (VTE) is relatively common among hospitalized patients, is often clinically silent, and is associated with substantial morbidity and mortality. Risk stratification and routine use of thromboprophylaxis for patients at moderate to high risk for VTE are key strategies that can be used to prevent VTE.


OBJECTIVE
To assess the appropriateness of the selection and implementation of thromboprophylactic measures for prevention of VTE within a South Australian teaching hospital.


METHODS
Guidelines for risk stratification and prophylaxis were compiled from a range of studies, consensus statements, and tertiary references. Using prospective, observational methodology, data collection was performed through case note audit for 130 inpatient admissions over a 4-week period.


RESULTS
The decisions regarding the usage of thromboprophylaxis were considered inappropriate in 32% of cases in the study cohort. Suboptimal practices were also observed with respect to factors including the choice between mechanical and pharmacologic methods and the timing of initiation and cessation of thromboprophylaxis.


CONCLUSIONS
These findings provide evidence suggesting that the selection and implementation of thromboprophylaxis require improvement and that appropriate means to facilitate this improvement need to be developed and evaluated through future research.
D000368:Aged; D003625:Data Collection / Q000379:methods; D003657:Decision Making; D005260:Female; D015276:Health Care Rationing; D006784:Hospitals, Teaching; D006801:Humans; D008297:Male; D009017:Morbidity; D018579:Patient Selection; D017410:Practice Guidelines as Topic; D011446:Prospective Studies; D013021:South Australia; D015912:Thrombolytic Therapy / Q000379:methods*; D013997:Time Factors; D017211:Treatment Failure; D020246:Venous Thrombosis / Q000188:drug therapy* / Q000401:mortality / Q000517:prevention & control*