Clinical Practice for Venous Thromboembolism Prophylaxis in Patients Undergoing Oncological Surgeries.

Abstract

ObjectiveTo determine the proportion of patients receiving venous thromboembolism (VTE) prophylaxis after oncological surgeries as per the hospital standards and its comparison with the international guidelines.MethodologyIn the month of September 2019, all patients after elective oncological surgeries were reviewed for VTE prophylaxis administration and education. Results were shared with the department of surgery and Hospital Quality and Patient Safety Department. Education was provided to the relevant staff and hospital policy for VTE prophylaxis was revised followed by a loop audit which was done in October 2020. The primary endpoint was to compare the proportion of patients receiving prophylaxis as per the hospital guidelines.ResultsTotal 425 patients were included in this audit (209 in September 2019 and 216 in October 2020). Compliance with mechanical prophylaxis increased from 84.7 % to 98.6% and pharmacological prophylaxis improved from 39.7% (n=83) to 73.1% (n=158). Adherence to local protocols enhanced significantly from 1.9% (n=4) to 56.4% (n=122). The main cause of non-compliance was lack of risk assessment for VTE.ConclusionVTE prophylaxis can be improved by setting protocols in accordance with the international guidelines and local protocols. This can prevent significant morbidity and mortality in surgical patients as well as hospital costs.