Results of a venous thromboembolism prophylaxis program for hospitalized patients
Authors Cardoso LF, Krokoscz DV, Paiva EF, Furtado IS, Mattar Jr J, de Souza e Sá MM, de Lira AC
Received 5 December 2015
Accepted for publication 9 March 2016
Published 12 December 2016 Volume 2016:12 Pages 491—496
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Lucy Goodman
Peer reviewer comments 2
Editor who approved publication: Professor Daniel Duprez
Luiz Francisco Cardoso, Daniella Vianna C Krokoscz, Edison Ferreira de Paiva, Ilka Spinola Furtado, Jorge Mattar Jr, Marcia Martiniano de Souza e Sá, Antonio Carlos Onofre de Lira
Sírio Libanês Hospital, São Paulo, Brazil
Introduction: Venous thromboembolism (VTE) is the leading cause of preventable death in hospitalized patients. However, existing prophylaxis guidelines are rarely followed.
Objective: The aim of the study was to present and discuss implementation strategies and the results of a VTE prophylaxis program for medical and surgical patients admitted to a large general hospital.
Patients and methods: This prospective observational study was conducted to describe the strategy used to implement a VTE prophylaxis program in hospitalized medical and surgical patients and to analyze the results in terms of the risk assessment rate within the first 24 hours after admission, adequacy of the prophylaxis prescription, and prevalence of VTE in the discharge records before and after program implementation. We used the Mantel–Haenszel chi-square test for the linear trend of the data analysis and set the significance level to P<0.05.
Results: With the support of an institutional VTE prophylaxis committee, a multiple-strategy approach was used in the implementation of the protocol, which included continuing education, complete data recording using computerized systems, and continuous auditing of and feedback to the medical staff and multidisciplinary teams. Approximately 90% of patients were evaluated within the first 24 hours after admission, and no significant difference in this percentage was observed among the years analyzed. A progressive increase in adherence to protocol recommendations, from 63.8% in 2010 to 75.0% in 2014 (P<0.001), was noted. The prevalence of symptomatic VTE in the discharge records of patients decreased from 2.03% in 2009 to 1.69% in 2014 (P=0.033).
Conclusion: The implementation of a VTE prophylaxis program targeting adult patients admitted to a large hospital employing a multiple-strategy approach achieved high rates of risk assessment within 24 hours of admission, improved the adherence to prophylaxis recommendations in high-risk patients, and reduced the rate of VTE events in the discharge records.
Keywords: deep venous thrombosis, pulmonary embolism, prevention and control, patient safety, quality control
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