Venous Thromboembolism Risk and Adequacy of Thromboprophylaxis in Surgical Patients

Venous thromboembolism (VTE) is the most prevalent potentially preventable complication amongst surgical patients. Appropriate prophylaxis is quite effective in its prevention. Mechanical and pharmacological thromboprophylaxis can be instituted based on risk categorisation. This study was undertaken to assess the risk for development of VTE in surgical patients and to assess the adequacy of thromboprophylaxis. A descriptive research design was used and was conducted in the general surgical wards of a tertiary hospital in South India. All 385 patients who were admitted in the surgical wards during the data collection period were included in the study, and the VTE Risk Assessment Tool by the Department of Health (2008b), UK, was used to assess the VTE risk in these patients. Eighty per cent of the patients were at high risk for developing VTE, and majority (62.7%) of them were not on any method of thromboprophylaxis. Only a minority (11.7%) of those who belonged to moderate or low risk were found to be on thromboprophylaxis. Majority of the patients who were found to be at high risk and were on prophylaxis for VTE were on anti-embolism stockings. More than half of the patients who were at low or moderate risk for VTE were found to be on injection heparin administered subcutaneously. There was a statistically significant association between age, type of occupation, the number of days of hospital stay, type of surgery, mobility level of patients and the VTE risk. Implementation of VTE risk assessment tool and a protocol for thromboprophylaxis helps in prevention of VTE and the complications associated with thromboprophylaxis. Incorporating this topic as a regular in-service education can ensure its mandatory learning and practice by nurses – the front line caregivers.