Objective: To present an alternate Venous Thromboembolism (VTE) prophylaxis risk stratification tool, based on NICE guidance. To evaluate the efficacy, ease of use and benefit of our tool, through cyclical audit.
Methods: Initial standards based audit of departmental VTE prophylaxis against NICE guidelines. Intervention: Design and introduction of a compulsory, nurse led, VTE risk stratification tool accompanied by staff training sessions and instructional posters. Re-audit of implementation and effectiveness 3 and 9 months later.
Results: of the 24 patients reviewed in the standards based pilot audit, none were assessed for their risk of VTE and 44% received sub-optimal treatment. Re-audit of 22 patients, 9 months after implementation of the risk stratification tool, showed 100% compliance with VTE risk stratification and 100% of patients were provided with optimal prophylaxis during their hospital stay.
Conclusion: The incidence of VTE in Otolaryngology patients is low and many of them fully mobile after short operations. The VTE risk stratification tool presented here is ideal for this cohort of patients as it treats patients based on their cumulative risk rather than for a single risk factor as suggested by the NICE flowchart.
A Compulsory, nurse-led policy, accompanied by staff training and educational posters proved successful in improving compliance with published guidance in our department. We would urge other ENT units to adopt a similar policy.