Current practice of venous thromboembolism prevention in acute trusts: a qualitative study

Abstract

ObjectiveTo explore the current practice of venous thromboembolism (VTE) prevention in acute trusts.DesignA qualitative research design was used to explore the perceived current practice of thromboprophylaxis, and knowledge and experience of VTE prevention. Data were collected via interviews with personnel from acute trusts and other relevant organisations and charities. Constant comparison was used to generate themes grounded in the data.SettingThe UK.Participants17 participants, sampled due to their expertise and knowledge in the field of VTE, were interviewed for the study.ResultsNo one felt directly responsible for VTE risk assessment and treatment in acute trusts. There were concerns whether any action takes place based on the risk assessment. Low levels of VTE knowledge existed throughout the system.ConclusionsOur study highlights the importance of continuous training to prevent VTE risk assessment being considered a tick box exercise and for clinicians to understand the significance of the procedure to ensure that VTE preventative measures are administered. It is essential that acute trust staff acknowledge that VTE prevention is the responsibility of everyone involved in a patient's care. Concerns remain around prophylaxis treatment, administration and contraindications.

Venous Thromboembolism Audit; where are we now and how can we improve?

“…medical and surgical. It has been previously reported [32] that nurses lack confidence to cascade information on VTE prevention to their patients. However, VTE prevention is a multidisciplinary responsibility.…”

Assessment of the public's knowledge of venous thromboembolism

“…One finding was confusion about which member of the health care team was responsible for risk assessment and management of VTE. 9 A similar study by Gao and Kause 10 found that 90% of physicians, nurses, and pharmacists in 1 facility recognized VTE as an issue and were aware of the prevention tools available. Despite this seemingly high knowledge level, only 52% of physicians completed VTE prophylaxis labels on admission 9,10 ; the study also highlighted that, with shorter hospital stays, many cases of VTE are missed in patients after discharge.…”

Accuracy of venous thromboembolism assessment and compliance to prophylaxis in a tertiary care center

“…The ACCP guidelines are updated every three years and are the most frequently cited standard for the prevention and treatment of VTE. 3,4,[6][7][8]11,12 Despite this, the Epidemiologic International Day for the Evaluation of Patients at Risk for Venous Thromboembolism in the Acute Hospital Care Setting (ENDORSE) study found that worldwide, appropriate VTE prophylaxis was not being administered. 4,6,7,12 Subsequently, numerous strategies have been employed to improve VTE assessment and prophylaxis practices, including the use of electronic alerts, education, and computerized clinical decision support (CDS) tools which utilize an electronic medical record (EMR).…”

“…3,4,[6][7][8]11,12 Despite this, the Epidemiologic International Day for the Evaluation of Patients at Risk for Venous Thromboembolism in the Acute Hospital Care Setting (ENDORSE) study found that worldwide, appropriate VTE prophylaxis was not being administered. 4,6,7,12 Subsequently, numerous strategies have been employed to improve VTE assessment and prophylaxis practices, including the use of electronic alerts, education, and computerized clinical decision support (CDS) tools which utilize an electronic medical record (EMR). 1,2,5,9,10,[13][14][15][16][17][18] Most institutions have implemented interventions that integrate into the patient care process to improve VTE assessment and ordering of prophylaxis.…”