752 VTE Prophylaxis and VTE Assessment Form in Plastic Surgery: A Closed-Loop Audit

Aim Failure to conduct a risk assessment and administer suitable venous thromboprophylaxis in surgical patients is deemed as negligence. It was estimated that 25,000 deaths in the UK was due to VTE in 2004-2005. Seventy percentage of hospital acquired VTE is potentially preventable with appropriate VTE prophylaxis. The Trust published a form for risk assessment for VTE for surgical patient. Our aim was to examine the departments adherence to the trust guidelines. Method All plastic surgery inpatients with a stay longer than 24 h were reviewed for VTE prophylaxis prescription for a period of two weeks. This was followed by presenting the audit results in a departmental meeting and introducing a checkbox to the handover list with posters placed in the doctors’ office. VTE assessment forms were placed in a clear divider and attached to the poster to remind doctors. Two weeks later, a re-audit was undertaken. Results In first audit, 22 patients were eligible for VTE prophylaxis compared to 24 in the re-audit. VTE chemoprophylaxis prescribing improved after intervention from 69.5% to 95%. Mechanical prophylaxis increased by 15.8%. Most importantly, the use of the VTE risk assessment form improved from 0 to 70%. Inappropriate chemoprophylaxis prescription reduced from 18.8% to 8%. Conclusions Despite the improvement in results after educating doctors and introducing the checkbox, our goal to be 100% compliant has not yet been met. Given the nature of the rapid turnover of junior doctors, a more robust system incorporating VTE assessment in the electronic system and replacing the paper form is required.