Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Dec 1;17(8):e1341-e1345.
doi: 10.1097/PTS.0000000000000521.

Improving Venous Thromboembolism Prophylaxis Administration in an Acute Surgical Unit

Matthew G R Allaway  1 , Guy D Eslick, Grace T Y Kwok  1 , Michael R Cox
Affiliations

Improving Venous Thromboembolism Prophylaxis Administration in an Acute Surgical Unit

Matthew G R Allaway et al. J Patient Saf. .

Abstract

Objectives: Venous thromboembolism (VTE) prophylaxis regimes frequently have a wide variation in application. Nepean acute surgical unit was established in 2006 as a novel model for emergency surgical care. As part of the model's rollout, there were several areas of clinical management targeted for improvement, one being VTE prophylaxis compliance. It was decided all patients older than 18 years treated for a variety of acute surgical conditions within the acute surgical unit should be administered routine VTE prophylaxis with heparin and compression stockings. A novel multifaceted intervention was implemented at the time to achieve this goal. The primary aim of this study was to determine VTE prophylaxis administration rates before and after this intervention.

Methods: A before-after study conducted as a retrospective review of medical records of all patients 18 years or older, having an appendicectomy in 3 periods: Before acute surgical unit (ASU) (November 2004 to October 2006), Early ASU (November 2006 to October 2008), and Established ASU (January 2012 to December 2013). Outcomes were mechanical and pharmacological VTE prophylaxis administration rates for each group.

Results: There were 1149 patients included in the study: Before ASU, 167; Early ASU, 375; and Established ASU, 607. There was a significant stepwise increase in parmacological VTE prophylaxis administration: Before ASU, 54.5%; Early ASU, 74.7%; and Established ASU, 96.9% (Before versus Early: odds ratio [OR], 2.46; 95% confidence interval [CI], 1.68-3.61; P < 0.001; Early versus Established: OR, 10.500; 95% CI, 6.29-17.53; P < 0.001). Mechanical VTE prophylaxis was significantly increased in the established group (Before versus Established: OR, 47.18; 95% CI, 25.61-86.91; P < 0.001).

Conclusions: There was a significant increase in VTE prophylaxis administration after the implementation of our multifaceted intervention. Allocating a responsible provider dedicated to VTE prophylaxis prescription and compliance checking was a key component to this intervention.

PubMed Disclaimer

Conflict of interest statement

The authors disclose no conflict of interest.

References

    1. Raskob GE, Angchaisuksiri P, Blanco AN, et al. Thrombosis: a major contributor to global disease burden. J Thromb Haemost . 2014;12:1580–1590.
    1. MacDougall DA, Feliu AL, Boccuzzi SJ, et al. Economic burden of deep-vein thrombosis, pulmonary embolism, and post-thrombotic syndrome. Am J Health Syst Pharm . 2006;63(20 suppl 6):S5–S15.
    1. National Health and Medical Research Council. Stop the Clot: Integrating VTE prevention guideline recommendations into routine hospital care (3rd ed). Melbourne: National Health and Medical Research Council;2011.
    1. Chong BH, Braithwaite J, Harris MF, et al. Venous thromboembolism - a major health and financial burden: how can we do better to prevent this disease? Med J Aust . 2008;189:134–135.
    1. Preventing venous thromboembolism in hospitalised patients. [Internet]. Melbourne; 2003. Available at: https://www.nhmrc.gov.au/_files_nhmrc/publications/attachments/nic46_evi... . Accessed July 15, 2018.

LinkOut - more resources