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Clinical studies in pulmonary embolism
P261 Questionnaire to assess acceptability of venous thromboembolism risk assessment tool by admitting doctors and nurses in the medical assessment unit of a district general hospital
  1. E K Nuttall,
  2. F Zaman
  1. Royal Blackburn Hospital, Blackburn, UK

Abstract

Introduction The House of Commons Health Committee estimated 25 000 people in the UK die from preventable hospital acquired venous thromboembolism (VTE) every year. The Department of Health now state all adult patients must have documented VTE risk assessment and have given guidance on thrombosis and bleeding risk factors based on guidance from the National Institute of Clinical Excellence (NICE). Our hospital trust has raised awareness of appropriate prescribing of thromboprophylaxis by alerts on the local intranet, posters in clinical areas, at staff inductions and the development of a VTE risk assessment tool that will be included in the new generic assessment document. The tool was audited with thromboprophylaxis prescribing and found that none of the tools were filled in correctly and 20 out of 50 patients (40%) were not prescribed thromboprophlaxis appropriately. We wanted to find out why these results occurred.

Method A questionnaire was given to 34 members of staff who are exposed to the new risk assessment forms; 16 doctors and 18 nurses.

Results All doctors were happy assessing VTE risk, whereas 61% of the nurses were not happy assessing all the risks included. The mean time to fill in the form was 4 min for doctors and nurses. 63% of doctors felt it should be a nursing job to fill in the risk assessment form whereas 77% of nurses felt it was a doctors job to complete the VTE risk assessment. 50% of doctors stated they used the risk assessment form when prescribing thromboprophylaxis and 62% of doctors felt they didn′t need a form to assess risk of VTE.

Conclusion The trust has used numerous ways to raise awareness of thromboprophylaxis prescribing, including the risk assessment tool. However, 40% of patients audited were not correctly prescribed thromboprophylaxis despite these measures. The majority of nurses felt it was a doctors job to fill in the tool as not all nurses were happy to assess all the risk factors. Only half the doctors stated they used the risk assessment tool and over half the doctors felt they didn't need a form to assess VTE risk.

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