Thromboprophylaxis in Patients Admitted to the Surgical Ward: Clinical Audit

Figures & data

Table 1 Type of Intervention

Intervention
Conservative	13(29%)
Elective	25(57%)
Emergency	6(13%)
Operation
Amputation	7
Open cholecystectomy	4
Debridement	4
Modified radical mastectomy	3
Thyroidectomy	3
Skin graft	2
Appendectomy	1
Hernia repair	1
Accessory breast removal	1
Laparoscopic cholecystectomy	1
Laparotomy	1
Breast abscess drainage	1
Hand abscess drainage	1
Anaesthesia
General	23(72%)
Local	6(19%)
Spinal	3(9%)

Table 2 Risk Factors for HAT

Cause of VTE Prophylaxis	Frequencies
Total anaesthetic + surgical time > 90 minutes	8
Age > 60	6
One or more significant medical comorbidities (heart disease, metabolic endocrine or respiratory pathologies, acute infectious diseases; inflammatory conditions)	6
Acute surgical admission with inflammatory or intra-abdominal condition	6
Active cancer or cancer treatment	5
Usage of oestrogen-containing contraception	5
Significantly reduction in mobility for >3 days	3
Surgery with significant reduction in mobility	3
BMI>30	2
Past or first-degree relative history of VTE	1

Table 3 Standard Criteria Application

Standard Criteria	1^st Cycle	2^nd Cycle
Use of risk assessment tool within 24 hours of admission	0 (0%)	23(92%)
Use of pharmacological prophylaxis within 14 hours of admission for eligible individuals	5(25%)	19(79%)
Counsel patients at risk about their risk	2(12%)	19(79%)
Counsel patients at risk about the consequences of DVT	0(0%)	19(79%)
Counsel patients at risk about the importance of prophylaxis	0(0%)	19(79%)
Counsel patients at risk about possible side effects of the prophylactic agent	0(0%)	19(79%)
Counsel patients at risk about how to reduce their risk	2(12%)	19(79%)
Upon discharge, counsel patients at high risk about the features of DVT and PE	0(0%)	19(83%)
Counsel patients who are discharged on pharmacological thromboprophylaxis about the correct usage and dose	n/a	19(90%)
Counsel patients who are discharged on pharmacological thromboprophylaxis about the necessity of taking the treatment for the recommended duration	n/a	19(90%)
Counsel patients who are discharged on pharmacological thromboprophylaxis about the side effects and when to seek medical help	n/a	19(90%)