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. 2020 Jun 8:19:e20190119.
doi: 10.1590/1677-5449.190119.

Venous thromboembolism prophylaxis protocols at Brazilian hospitals - PROTEV Brazil

Ana Thereza Cavalcanti Rocha  1 , Thiago Brito Pinheiro  1 , Paulo Roberto Sampaio Peixoto de Souza  1 , Marcos Arêas Marques  2
Affiliations

Venous thromboembolism prophylaxis protocols at Brazilian hospitals - PROTEV Brazil

Ana Thereza Cavalcanti Rocha et al. J Vasc Bras. .

Abstract
in English, Portuguese

Background: In common with other international guidelines, the Agency for Healthcare Research and Quality recommends implementation of venous thromboembolism (VTE) prophylaxis programs in hospitals as a measure for patient safety. The VTE Safety Zone Program (VTESZ) proposes a model for incorporation of systematic VTE risk-assessment into hospital routines, with continuing institutional and multidisciplinary participation.

Objectives: To evaluate implementation of VTE prophylaxis initiatives in Brazilian hospitals that have adhered to the VTESZ Program.

Methods: Questionnaires were e-mailed to VTESZ Program representatives at hospitals visited up to July 2016.

Results: Of the 132 invitations sent, 68 answers were obtained and 50 (73.5%) were complete. 61.5% of participating hospitals had between 100 and 250 beds, and 65.4% had more than 20 intensive care beds; 61.5% reported having hospital accreditation, 86.3% had VTE prophylaxis committees, and 58% had electronic medical records. VTE risk assessments using the Brazilian guidelines or the Padua or Caprini scores were noted on the electronic medical record in 56.9% and were a mandatory step in 45.1% of the cases. VTE risk reassessment was requested prior to discharge in only 25% of hospitals and several issues were cited that negatively affect the VTESZ implementation process.

Conclusions: This study provides an overview of implementation of VTESZ in Brazilian hospitals. Systematic risk assessment is not yet conducted for most patients. Recognition of various issues affecting the process may lead to new strategies for achieving adequate prophylaxis and safety of hospitalized patients.

Contexto: Implementar um programa para profilaxia de tromboembolismo venoso (TEV) em hospitais é uma recomendação de diretrizes internacionais e da Agency for Healthcare Research and Quality para segurança dos pacientes. O Programa TEV Safety Zone (TEVSZ) é um modelo que sugere avaliação sistemática do risco de TEV incorporada às rotinas do hospital com participação institucional e multidisciplinar continuada.

Objetivos: Levantar dados de implementação de iniciativas para profilaxia em hospitais brasileiros que iniciaram o Programa TEVSZ.

Métodos: Envio de questionário por correio eletrônico aos responsáveis pelos programas TEVSZ em hospitais visitados até julho de 2016.

Resultados: Dos 132 convites enviados, foram obtidas 68 respostas, sendo 50 (73,5%) completas. Em 61,5% dos hospitais participantes havia entre 100 e 250 leitos, e 65,4% tinham mais de 20 leitos de terapia intensiva; 61,5% referiam ter acreditação hospitalar, 86,3% tinham comissão de profilaxia de TEV e 58% tinham prontuários eletrônicos. As avaliações de risco de TEV pela diretriz brasileira, escores de Pádua ou Caprini eram feitas no prontuário eletrônico em 56,9% e como passo obrigatório em 45,1% dos casos. Em apenas 25% dos hospitais, a reavaliação do risco de TEV era solicitada antes da alta, e foram citadas várias barreiras no processo de implementação do TEVSZ.

Conclusões: O estudo mostra um panorama da implementação do TEVSZ em hospitais brasileiros. As avaliações sistemáticas de risco ainda não ocorrem na maioria dos pacientes. O reconhecimento de diversas barreiras no processo pode levar a novas estratégias para a adequação da profilaxia e segurança dos pacientes hospitalizados.

Keywords: patient care management; patient safety; prevention and control; protocols; venous thromboembolism.

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Conflict of interest statement

Conflicts of interest: No conflicts of interest declared concerning the publication of this article.

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