Venous Thromboembolism Prevention in General Surgery: A Closed Loop Clinical Audit of Risk Assessment and Prophylaxis Adherence

普通外科静脉血栓栓塞预防:风险评估和预防依从性的闭环临床审核

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Abstract

BACKGROUND: Venous thromboembolism (VTE) is a major preventable cause of morbidity and mortality in hospitalized patients. Despite established guidelines for risk assessment and prophylaxis, adherence can vary. METHODS: A two-cycle clinical audit was conducted on general surgery admissions at a district general hospital to assess adherence to National Institute for Health and Care Excellence (NICE) and local guidelines for VTE risk assessment, timely completion, and prescription of pharmacological and mechanical prophylaxis. Cycle 1 audited patients between February 7, 2023 and February 18, 2023 (n=54) and Cycle 2 audited patients between July 10, 2023 and July 17, 2023 (n=57). Interventions included education and feedback after the first cycle. RESULTS: In Cycle 1, 75.9% had a risk assessment completed at any time, and 53.7% within 24 hours. Pharmacological VTE prophylaxis was prescribed in 81.5%, and 29.6% received mechanical prophylaxis. In Cycle 2, completion improved to 93%, with 59.6% completed within 24 hours. Pharmacological prophylaxis was prescribed appropriately in 100%, but only 25% received mechanical prophylaxis. CONCLUSIONS: The audit demonstrated significant improvement in pharmacological VTE prophylaxis prescription and risk assessment completion following targeted interventions, but mechanical prophylaxis adherence decreased slightly and remains an area for improvement. Regular audits and sustained education are essential to maintain and enhance compliance.

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