WTP6.5 Facile strategies implemented to improve pharmacological venous thromboembolism prescribing practices in an acute surgical assessment unit

Abstract

Abstract Introduction Venous thromboembolism (VTE) represents a major cause of preventable morbidity and mortality in acute surgical admissions. Whilst previous national audits/NHS campaigns have greatly increased admission VTE prophylaxis assessment (VTEPA), critical reassessment within 24 hours of admission in high bleeding/thrombosis risk patients as advocated by NICE/SIGN/Trust guidelines remains poor; thus, serving as the study aim. Methods Data collection was undertaken retrospectively post-discharge (n=269) at admission (within 14 hours post-admission) and reassessment (within 24 hours post-admission). The first cycle determined baseline practices; intradepartmental poster education/sessions and discussion awareness formed the mainstay intervention with a further 2 cycles (2 months/4 months post-intervention) to assess change. An unpaired T-test determined significance (p<0.05) of averaged VTEPA rates across cycles. Results Baseline VTEPA practices 92% (admission) and 16% (reassessment) of patients respectively. VTEPA rates significantly improved to 98% (admission, p<0.05) and 86% (reassessment, p<0.001) 2 months post-intervention. At 6 months VTEPA rates decreased to 96% (admission) and 62% (reassessment); p<0.05, p<0.001 compared to baseline practice respectively. Discussion VTEPA significantly improved post intradepartmental poster-education and discussion awareness at admission and reassessment, in accordance with national guidelines. We consider the decline in VTEPA at 6-months, partly attributed to the influx of the new cohort of FY1 junior doctors in August with limited exposure to the departmental VTE education sessions. Overall, however, this audit demonstrates that facile, inexpensive, and quick interventions can yield highly effective results translating into improved patient safety; particularly in preventable inpatient VTE events. Further consideration should be given to incorporate such strategies across trusts to maximise VTEPA compliance.