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Simple interventions improve adherence to thromboprophylaxis guidelines
Deborah Wright, M Fancourt, W Gilkison, F El-Haddawi, S Kyle, D Mosquera
Department of Surgery, Taranaki Base Hospital, New Plymouth, New Zealand
Aim
Thromboprophylaxis is the responsibility of every surgeon. The aims of this study were
1. To compare performance with Australasian Guidelines on Venous Thromboprophylaxis and 2. To determine whether simple interventions changed performance.
Methods
This was a 12 month prospective study on a general surgical ward in a provincial New Zealand Hospital . A snapshot assessment of thromboprophylaxis was performed on all ward patients on 22 occasions using a structured survey instrument (13 pre-intervention and 9 post intervention).
Intervention consisted of education of staff, drug chart modifications and placement of alert stickers.
Results
A total of 174 patients were assessed, 100 pre-intervention and 74 post intervention.
Anti-embolism stockings were appropriate in 50% of pre intervention ward patients (50 of 50) and 85% (63 of 74) post intervention (p<0.001, c2). Enoxaparin was appropriate in 46% (46 of 100) and 69% (51 of 74) of pre and post intervention patients respectively (p= 0.004).
Exact adherence to post operative guidelines occurred in 25% (25 of 100) patients pre-intervention and in 62% (46 of 74) post intervention (p<0.01 ), although most patients (85%) received some form of prophylaxis.
Conclusions
Adherence to thromboprophylaxis guidelines can be improved by simple, cheap, transferrable interventions.
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