714 Venous Thromboembolism Risk Re-Assessment Within 24 and 72 Hours After Admission (Closed-Loop Audit)

Introduction NICE and Poole Hospital guideline state venous thromboprophylaxis (VTE) risk assessment must be done on admission and at consultant review (within 24hr and 72hr after admission) Changing from paper to electronic patient records(EPR) system omits some mandatory protocols. Although VTE risk assessment on admission remains mandatory on EPR, records of re-assessment within 24 and 72hr becomes optional. Method 100 random patients admitted to the orthopaedic department, before and after implementation of change. Results The initial data indicates 0% of recording for re-assessment after admission. This action led to incorrect dosage and duration of chemical VTE prophylaxis in 20% of the patients. After presenting the data to stakeholders, an instruction of entering VTE re-assessment on EPR was done by a teaching session and by putting up posters. A discussion with the IT department resulted in setting up a dropdown-box for VTE re-assessment on EPR. Re-audit shows a slight improvement in the recording from 0% to 3% for within 24hr and 22% for within 72hr. Feedbacks indicates an insufficient time, a lack of senior staff member involvement and established workplace culture. Conclusions Despite some improvement, more junior and senior staff engagement, including cultural changes, are needed to achieve the national standard.