Venous thromboembolism: reducing the risk in a Role 3 setting

Area of Science:

• Medical Research
• Patient Safety
• Clinical Audit

Background:

• Venous thromboembolism (VTE) is a major preventable cause of hospital mortality.
• VTE assessment and prophylaxis are critical patient safety indicators.
• Current guidelines for VTE prophylaxis require auditing.

Purpose of the Study:

• To audit the prescription rates of low molecular weight heparin (LMWH) and graduated elasticated compression stockings (GECS).
• To compare prescription rates with current Clinical Guidelines for Operations.
• To evaluate the effectiveness of an intervention program to improve VTE assessment and prophylaxis.

Main Methods:

• A complete audit loop was conducted at Role 3 Hospital, Camp Bastion, Afghanistan.
• A multifaceted intervention included physician and nurse education.
• Pre-printed medication charts were introduced to improve VTE assessment and prophylaxis rates.

Main Results:

• VTE risk assessment improved from 36.9% to 91.6% post-intervention.
• Bleeding risk assessment documentation increased from 64.8% to 98.5%.
• LMWH prescription for at-risk patients improved from 64.6% to 91.9%, and inappropriate prescriptions decreased.

Conclusions:

• Pre-printed LMWH/GECS prescriptions and risk assessment stickers significantly improved VTE risk assessment and prophylaxis.
• These interventions are easily reproducible and low-cost.
• The study demonstrates a potential to improve patient safety during deployment.