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Protocol violation in deep vein thrombosis prophylaxis

B D George1, T A Cook, I J Franklin

  • 1Department of Surgery, Royal Berkshire Hospital, Reading.

Annals of the Royal College of Surgeons of England
|May 14, 1998
PubMed
Summary
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See all related articles

Deep vein thrombosis (DVT) prophylaxis policy adherence is low in general surgery. Policy changes reduced violations but did not improve overall thromboprophylaxis care for surgical patients.

Area of Science:

  • Medical research
  • Surgical practice
  • Public health

Background:

  • Deep vein thrombosis (DVT) prophylaxis is crucial in general surgery.
  • Adherence to established DVT prophylactic policies varies significantly in clinical practice.

Purpose of the Study:

  • To assess adherence to DVT prophylactic policies in general surgery.
  • To identify reasons for non-adherence and evaluate the impact of policy modifications.

Main Methods:

  • An initial audit of DVT prophylaxis in 60 surgical patients under 6 surgeons with individual protocols.
  • A follow-up audit 1 year after implementing a uniform departmental DVT prophylaxis policy, studying 58 surgical patients.

Main Results:

  • Initially, 50% of patients did not receive DVT prophylaxis per policy; 43% of violations had acceptable clinical reasons.

Related Experiment Videos

  • After policy unification, protocol violations decreased to 27%, with no acceptable clinical reasons for violations.
  • Unacceptable violations remained similar, and preoperative prophylaxis for high-risk patients did not improve.
  • Conclusions:

    • DVT protocol violations are frequent in general surgical settings.
    • While policy unification reduces violations, it has a limited effect on the overall standard of thromboprophylactic care.
    • Further strategies are needed to enhance DVT prophylaxis adherence and effectiveness.