Venous thromboembolism prophylaxis risk assessment in a general surgery cohort: a closed-loop audit.
OBJECTIVE
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%).


CONCLUSIONS
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.
Department of Surgery, Cork University Hospital, Wilton, Cork, Ireland. davidmcgoldrick@gmail.com.
D M
DM
McGoldrick
Department of Surgery, Cork University Hospital, Wilton, Cork, Ireland.
H P
HP
Redmond
D000328:Adult; D015331:Cohort Studies; D005260:Female; D013502:General Surgery / Q000379:methods*; D006801:Humans; D008297:Male; D008485:Medical Audit / Q000379:methods*; D008875:Middle Aged; D018570:Risk Assessment; D012307:Risk Factors; D054556:Venous Thromboembolism / Q000473:pathology / Q000517:prevention & control*; D055815:Young Adult
Audit; Surgery; Venous thromboembolism