416 Venous Thromboembolism Prophylaxis in Emergency Surgical Admission: The Power of a Checkbox in Reducing Errors. a Closed Audit

Abstract

Abstract Introduction Hospital-acquired venous thromboembolism (VTE) is considered a significant cause of morbidity and mortality in all inpatients. It is potentially preventable with adequate thromboprophylaxis. All surgical patients should be assessed and commenced on an appropriate dose of anticoagulant agent. Drug charts of 40 patients admitted under general surgery teams at Galway University Hospital were reviewed and audited against the Irish VTE prophylaxis guidelines release in 2019. Results A total of 40 (21 M, 19 F) patients were included, 2 out of the 40 patients (30%) were adequately assessed not suitable for chemoprophylaxis, two patients were not missed in the absence of risk factors of bleeding. Of the remaining 36 patients, 29 were adequately treated with chemoprophylaxis and 7 patients were undertreated or overtreated by doses inadequate to their weight and renal clearance. 35 out 40 patients were charted for TED stockings this falls under the 100% standard. Intervention: An educational presentation, along with collaborative agreement with the pharmacy department to add two checkboxes on the prophylactic anticoagulant page of the carder to highlight the renal function and the weight to the prescriber. Re-audit: On re-auditing the data, 40 patients were included, 2 patients have contraindications factors for anti-coagulant. out of 38 patients remaining, 37 of them received weight and renal function-adjusted doses of prophylactic anticoagulants. All 40 patients received TED stockings. Conclusions Check boxes on the prescription sheet act as effective reminders for the busy junior doctor prescriber to highlight the importance of weight and renal function when prescribing anti-coagulants.