575 Are More Patients Being Harmed Than Treated with VTE Prophylaxis in Plastic Surgery? A Single-Centre Cycled Audit Reviewing Prescribing Practices

Abstract

Abstract Aim Venous thromboembolism prophylaxis (VTEP) was introduced following research showing that it was successful at preventing thrombotic complications in surgery patients. However, recent evidence demonstrates that patients in this cohort had subclinical venous thromboembolic disease and the benefit of VTEP was over-estimated. The Number Needed to Harm (NNH) is 26–67 while the Number Needed to Treat (NNT) is 147. This retrospective analysis attempted to identify if incorrect prescriptions in patients undergoing plastic surgery was possibly causing greater harm in a single plastic surgery centre. Method A retrospective analysis of the notes of all admissions in 1 month was conducted. VTEP forms and prescriptions were reviewed and compared against recommendations from the National Institute for Health and Care Excellence as well as local policy. A teaching session was delivered to explain to the department issues with prescriptions, then another 1 month of notes were analysed. Results Conclusion There was an over-prescription of VTEP in plastic surgery patients in our cohort leading to a potential greater number of harmed than treated patients. This may require an attitude change towards VTEP to reduce patient harm.