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General Orthopaedics

AN AUDIT OF VENOUS THROMBO-EMBOLIC (VTE) PROPHYLAXIS WITH A NOVEL IDEA OF ENSURING NICE GUIDELINES ADHERENCE IN ORTHOPAEDICS

The Indian Orthopaedic Society (UK) (IOSUK)



Abstract

Introduction

‘VTE disease is the new MRSA’, with much attention received in the media and the political world. Following the 2010 NICE guidelines all patients admitted to hospital should have VTE prophylaxis considered and a formal VTE risk assessment done with documentation and review in a 24 hour period. We carried out a completed audit cycle to identify our adherence to these guidelines and introduced a novel method to ensure compliance.

Materials/Methods

An audit of 400 patients admitted to the orthopaedic department was carried out with review of case notes. Three key parameters were investigated: Firstly the compliance of carrying out a risk assessment for VTE disease with correct documentation, secondly investigating how many patients got re-assessed in 24 hours and finally if patients received appropriate VTE prophylaxis. The data was re-audited following the introduction of a new drug chart with a box section for VTE risk assessment and prophylaxis on the chart itself.

Results

In the first cycle VTE risk assessments were carried out in 2.5% with 0% having a re-assessment in 24 hours and 93.5% of patients having correctly prescribed VTE prophylaxis. Following the new drug charts, the risk assessments were carried out in 79%, re-assessment in 50% and correct prescribed prophylaxis in 99% of the patients.

Conclusions

We recommend all hospitals should have a section in the drug chart itself for VTE risk assessment and prophylaxis as this greatly improves compliance to the NICE guidelines. This ensures optimal patient care and protects the trust from litigations.