Original Research Article
Year: 2020 | Month: October | Volume: 10 | Issue: 10 | Pages: 54-61
Venous Thromboembolism Risk Assessment and Prophylaxis in Intensive Care Unit; Clinical Audit and Performance Improvement Project
Alfateh Sayed M. Noor1, Joy Anne Buning1, Taisy Joy Stephen1, Kriz Louie Odchigue1, Veronica Jini1, Waleed Th. Aletreby1
1Critical Care Department, King Saud Medical City, Riyadh, Saudi Arabia
Corresponding Author: Alfateh Sayed M. Noor
ABSTRACT
Venous thromboembolism is a major cause of morbidity and mortality among hospitalized patients, particularly the critically ill. High incidence rates continue to be reported despite the presence of several high quality prophylaxis guidelines. However, several gaps are frequently identified in the practice that may contribute to the incidence and prevalence of this plethora.
Objectives: To report the findings of a complete audit cycle on VTE risk assessment and prophylaxis in the intensive care unit of a major hospital in Saudi Arabia. As well as the results of a performance improvement project.
Results: The percentage of patients with completed VTE risk assessment in the first cycle was 89%, that increased to 96% in the second (p = 0.1), proper risk categorization was 74.2% and 90.6% in the first and second cycles respectively (p = 0.01), whereas the percentage of patients receiving the recommended prophylaxis dose was 86.4% in the first cycle, and 94.3% in the second (p = 0.2).
Conclusions: VTE risk assessment, proper risk categorization, and providing optimal prophylaxis doses remain below targets, however; all three parameters could be improved by performance improvement projects. As the main causes of sub-standard practices are related to awareness issues, in addition to underestimation of VTE risk in favor of over-estimation of bleeding concerns.
Key words: Venous thromboembolism, VTE risk assessment and prophylaxis in the intensive care unit, Clinical audit, pulmonary embolism (PE) and deep vein thrombosis (DVT)