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Audit in VTE prevention. Peter Davies Senior Pharmacist. Drivers for audit. Venous thromboembolic prevention is a DH patient safety priority NICE clinical guideline venous thromboembolism reducing the risk CQUIN The NHS standard contract for acute services and VTE prevention.

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Presentation Transcript
Audit in vte prevention

Audit in VTE prevention

Peter Davies

Senior Pharmacist


Drivers for audit
Drivers for audit

  • Venous thromboembolic prevention is a DH patient safety priority

  • NICE clinical guideline venous thromboembolism reducing the risk

  • CQUIN

  • The NHS standard contract for acute services and VTE prevention


Audit of vte currently being undertaken by the trust
Audit of VTE currently being undertaken by the Trust

  • VTE risk assessment audit

  • Clinical incident/Pharmacy intervention monitoring

  • Healthcare record audit

  • Root cause analysis of hospital

    acquired thrombosis

  • Rivaroxaban use in elective THR and TKR


Vte risk assessment
VTE risk assessment

  • Audit data since June 2008

  • Data collected from the front of the drug administration and record chart

  • 3 monthly data until May 2010 now monthly

  • CQUIN requirements



Clinical incident and pharmacy intervention reporting
Clinical incident and Pharmacy intervention reporting

  • Reporting forms adapted to include fields to record incidents and interventions relating to VTE prevention and prophylaxis

  • Report generated by clinical risk and sent monthly to the thrombosis committee


Healthcare records audit
Healthcare records audit

  • Data provided by individual wards

  • Audit of 5 sets of healthcare records

  • Record data on whether risk assessment and thromboprophylaxis is appropriate on an electronic data collection form

  • Data collated by clinical audit and forwarded to the Thrombosis committee


Root cause analysis of hospital acquired thrombosis
Root cause analysis of hospital acquired thrombosis

  • Hospital acquired thrombosis detected by

    DVT/Anticoagulant clinic

    Coding

    Diagnostics

    Autopsies

  • Subjected to a root cause analysis

  • Reviewed by the Thrombosis committee


Rivaroxaban thromboprophylaxis following elective thr and tkr
Rivaroxabanthromboprophylaxis following elective THR and TKR

  • For elective Primary THR or TKR

  • First dose 30 hours post surgery

  • 14 days for TKR and 35 days for THR

  • Contra-indicated e-GFR <30ml/min

  • Not used if on long term anticoagulant


Number of patients prescribed dalteparin in place of rivaroxaban
Number of patients prescribed dalteparin in place of rivaroxaban