Abstract Background venous thromboembolism (VTE) accounts for the majority of preventable in-hospital deaths and is associated with increased costs and longer hospital stays1,2. Mechanical and pharmacological prophylaxis reduces the incidence of VTE and should be prescribed on admission in accordance with NICE guidelines1. Aims to assess the prescribing and administration of VTE prophylaxis in elective and emergency surgical admissions and ascertain whether a VTE risk assessment was documented. The departmental standard is that 100% of admissions should be prescribed prophylactic dose low molecular weight heparin (pLMWH) and thrombo-embolus deterrent (TED) stockings within 24 hours. Method a prospective analysis of adult surgical patients admitted throughout November 2024 was performed using data from Hepma, clerking booklets and patient observation. Patients with contraindications to pharmacological or mechanical VTE prophylaxis were excluded. Results 49 emergency and 12 elective admissions were included. VTE risk assessment was documented within 24 hours in 32.7% of emergency and 0% of elective admissions. 65.3% of emergency admissions had pLMWH prescribed within 24 hours, compared to 100% of elective. 87.8% of emergency admissions had TEDs prescribed but only 18.6% were wearing stockings. 75% of elective admissions were wearing TEDs; 0% had these prescribed. Conclusion current provision of VTE prophylaxis in our department falls below the expected standard and NICE guidelines. There is discordance between admitting doctors and those completing the online prescribing who are frequently more junior. Better education and communication is needed. Proposed interventions include a departmental education session, posters and the addition of pLMWH to the surgical Hepma protocols.
Ferguson et al. (Fri,) studied this question.