Assessment And Enhancement Of Venous Thromboembolism Prophylaxis Protocols In Medical Unit Of Ayub Teaching Tertiary Care Government Hospital, KpK, Pakistan

Audit cycle

Abstract

Background : Venous thromboembolism (VTE) refers to the formation of blood clots within the venous system, a serious medical condition with potentially life-threatening consequences. The risk of developing VTE significantly increases during hospitalization due to factors such as reduced mobility and underlying illness. Therefore, it is crucial to perform timely risk assessments and implement appropriate prophylactic measures to prevent the occurrence of this preventable complication in hospitalized patients.

Aim and objectives: In developing countries, data on VTE prophylaxis remains limited, and in Pakistan, VTE prevention is often overlooked in research and clinical practice. This clinical audit was undertaken to assess current practices in VTE risk assessment and prophylaxis, with a focus on identifying gaps and evaluating the impact of educational interventions. By enhancing awareness and adherence to standard protocols, the aim is to improve patient care and reduce the risk of preventable complications."

Methodology: We used the National Institute for Health and Care Excellence (NICE) guidelines for VTE prophylaxis as our audit standard. In Phase A, conducted from January 20 to February 30, 2024,Data  was collected using a customized proforma by prospectively reviewing the medical records of 180 patients, admitted to the Medical Unit of Ayub Teaching Hospital. Following an educational intervention aimed at improving adherence to guidelines, Phase B was conducted from march 4 to april 10, 2024, reviewing an additional 150 patients to evaluate any changes in practice

intervention: For the intervention phase, findings from Phase A were presented during the monthly ward meeting, which was attended by the Head of Department, consultants, registrars, postgraduate residents, interns, and nursing staff of the medical unit. The session focused on educating healthcare providers about the risk factors associated with VTE and the critical need for timely prophylaxis. Additionally, educational posters were strategically displayed throughout the ward to reinforce the importance of adhering to VTE prophylaxis protocols.

Results: In Phase A, of the 180 patients assessed, 27 (15%) underwent risk assessment for VTE. Among those eligible for prophylaxis, only 18 patients (22.2%) received the appropriate prescriptions. Following the educational intervention, Phase B included 150 patients, where significant improvements were observed: all 150 patients (100%) were risk assessed for VTE, and 112 patients (75%) received the prescribed prophylaxis. This indicates a substantial improvement in adherence to VTE prophylaxis protocols after the intervention.

Conclusion: The audit revealed a lack of adherence to standard VTE risk assessment and prophylaxis prescribing practices initially. However, the implementation of a targeted educational intervention significantly improved compliance, leading to enhanced patient care regarding VTE prevention. This outcome underscores the value of clinical audits as effective tools for improving clinical practices and promoting better patient outcomes.

keywords: VTE prophylaxis, prevention, hospitalized patients, patient safety and quality improvement, venous thromboembolism, clinical audit process.