Audit of VTE prophylaxis risk assessment and prescribing for general medical inpatients

Abstract

Venous thromboembolism is a significant cause of morbidity and mortalityamongst hospitalised patients. The aim was to review the current level ofcompleteness of venous thromboembolism (VTE) prophylaxis risk assessmentdocumentation at Surrey and Sussex Healthcare NHS Trust. TheVTE prophylaxis risk assessment form is provided on Cerner and all doctorsare prompted to complete this when opening a patient record. The riskassessment proforma ensures that all patients who are assessed as either atmoderate or high risk of VTE during their admission receive pharmacologicalVTE prophylaxis or if contraindicated mechanical prophylaxis. Usingthe Trusts thromboprophylaxis guideline, six standards were defined. Thetarget for each standard is set at 100% and complies with national auditstandards for preventing hospital acquired VTE and PE. Results are shown further in the text:Ninety three per cent of admissions had documented assessments onadmission to hospital. 0.03% had VTE risk reassessed within 24 h- and some of these patients would have gone to other wards first, 12.5% had24 h reassessment documented which did not meet national targets.Limitations faced included: limited timeframe of data collection, smallsample size and prophylaxis could have been prescribed, but the clinicianhad not recorded the assessment on the electronic record (Cerner).These findings have been presented to our local general internal medicinedepartment. We plan to reaudit VTE compliance on another GIM ward.We expect findings to be similar; therefore we plan to implement a changeto improve compliance rates to the national standard. We will then reauditwithin 6 months to see if we have improved. I’m looking forward tothe results!