Improving venous thromboembolic disease prophylaxis in medical inpatients: a role for education and audit.
BACKGROUND
Venous thromboembolic disease (VTED) prophylaxis is a key strategy in reducing preventable deaths in medical inpatients. We assessed compliance with internationally published guidelines for VTED prophylaxis in at-risk medical patients before and 1 month after an educational intervention to enhance compliance with such guidelines.


RESULTS
One hundred and fifty patients were assessed on each occasion. Pre-intervention, VTED prophylaxis was prescribed in only 48% of at-risk cases. Compliance was best among patients under stroke services and worst for those under acute medical teams. Patients within specialist units were more likely to be prescribed prophylaxis than those in general wards (75 vs. 53%; p = 0.0019). Post-intervention, overall compliance improved to 63% (p = 0.041 for comparison). There was a significant improvement among general medical teams (48 vs. 75%; p = 0.001), and in general wards (52 vs. 74%; p = 0.003).


CONCLUSIONS
Thromboprophylaxis is under-prescribed in medical inpatients, but compliance with international guidelines can be significantly enhanced with targeted educational intervention.
Department of Pulmonary and Sleep Disorders, St. Vincent's University Hospital, Dublin 4, Ireland. briankent@physicians.ie
B D
BD
Kent
P
P
Nadarajan
N B
NB
Akasheh
I
I
Sulaiman
S
S
Karim
S
S
Cooney
S J
SJ
Lane
E D
ED
Moloney
D019983:Guideline Adherence; D006760:Hospitalization; D006801:Humans; D008485:Medical Audit; D010353:Patient Education as Topic; D012307:Risk Factors; D020521:Stroke / Q000150:complications; D054556:Venous Thromboembolism / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*