839 Venous thromboembolism assessment!! Are we doing it?

Abstract

<h3>Aims</h3> Pulmonary Embolism/Deep Vein Thrombosis (VTE) are one of the biggest causes of mortality in the hospital. Nice Guidelines NG89 (2019) mandates assessment of all patients over age 16 year to identify the risk of VTE and bleeding within 6 hours of admission and administration of prophylactic therapy within 14 hours if deemed necessary. National VTE Prevention Program has reduced post-discharge VTE deaths in England by 20.8% between 2007/8 and 2018/19. Our aim was to assess compliance with local VTE assessment and prophylaxis policy within our paediatric in-patient unit in a District General Hospital that stipulates VTE assessment within 24hours of admission. <h3>Methods</h3> We looked at all young people over age 16 year admitted to paediatric department between 1st January and 31st August 2021. Hospital Electronic Patient Records and Electronic Observations System was queried to extract to collect demographics, diagnosis, admitting team, VTE assessment status and treatment status. The data was populated in Microsoft Excel 365 worksheet and analysis was performed using Microsoft PowerQuery and PivotTables. <h3>Results</h3> A total of 105 (n=105) young people over age 16 year were admitted during audit year. 36.1% of those patients (n=39) had VTE assessment. 35.2% (n=37) had the VTE assessment within 24 hours as per hospital VTE policy. Young people admitted for mental health problems in shared care with CAMHS constituted 69.64% of total admissions. Only 23% of the patients stayed over 24 hours in the ward, and 40% were discharged within 12 hours of admission and 25% were discharged within 6 hours. <h3>Conclusion</h3> This first audit demonstrated that overall VTE compliance within the paediatric department was suboptimal. Improvements are required to ensure timely assessment and prescribing of appropriate VTE prophylaxis. The fact that VTE Prevention Program is not embedded in general paediatric practice and very short length of stay effected compliance with local policies. We have undertaken additional VTE prophylaxis teaching for all staff grade and produced visual aids and reminders to enhance, guide and facilitate appropriate VTE prescribing. A second cycle audit is planned to determine knowledge, adherence, and ensure compliance with hospital and national guidelines.