EP.FRI.835 5 Years, 4 F1s, 3 Registrars, 2 Pandemic Waves, 1 VTE audit: Half a decade of VTE prophylaxis on a surgical ward

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Helena Colling Sylvester ◽  
Naim Slim ◽  
Michael Okocha
Keyword(s):  
Venous Thromboembolism ◽  
Hospital Admission ◽  
Vte Prophylaxis ◽  
The Third ◽  
Surgical Ward ◽  
Fourth Cycle ◽  
Assessment Unit ◽  
Prescribing Practice ◽  
Electronic Prescriptions ◽  
Preventable Complication

Abstract Aim Venous thromboembolism(VTE) is a preventable complication of hospital admission. This audit aims to compare VTE prophylaxis over 5 years in one surgical assessment unit and identify areas for improvement. Methods This was a snapshot, 5-cycle audit of the analysis of VTE risk, prescribing practice and prophylactic therapies offered at admission. We prospectively reviewed notes of patients admitted under general surgery over a snapshot period annually. Data was compared to figures collected over four previous years. Induction VTE prophylaxis teaching was introduced after the first cycle, HCA VTE champions were introduced after the second, digital reminders were introduced after the third, and monthly email reminders sent after the fourth cycle. Results VTE risk was documented for 92% of patients in 2017, 65% in 2018, 57% in 2019, 76% in 2020 and 53% in 2021.  In the years 2017, 2018, 2019, 2020, 2021, Enoxaparin was prescribed for 96%, 68%, 75%, 55% and 73% of patients respectively. In 2017, 2018, 2019, 2020 and 2021, TED stockings were prescribed for 96%, 68%, 62%, 50% and 73% of patients respectively. Conclusions We utilised a multidisciplinary and digital approach against the issue of VTE prophylaxis on surgical wards. Despite best efforts, compliance was highly fluctuant with a drop during the first wave of the pandemic. This has demonstrated that with redistribution of regular nursing and medical staff, new patient filtering systems and increased healthcare pressures, previous mechanisms cannot be relied upon. We have began the process of electronic prescriptions with mandatory VTE prophylaxis checklists.

Venous thromboembolism (VTE) prophylaxis

2018 ◽  
pp. 121-126
Author(s):  
Abdullah Jibawi ◽  
Mohamed Baguneid ◽  
Arnab Bhowmick
Keyword(s):  
Risk Assessment ◽  
Venous Thromboembolism ◽  
Low Molecular Weight Heparin ◽  
Surgical Patients ◽  
Related Factors ◽  
Vte Prophylaxis ◽  
Vein Thrombosis ◽  
Deep Vein ◽  
Preventable Complication ◽  
Fatal Complications

Venous thromboembolism is a common but largely preventable complication following surgery. However, fatal complications can occur as a result of pulmonary embolism following deep vein thrombosis. A structured risk assessment should be performed preoperatively in all surgical patients and thromboprophylaxis measures should be tailored according to patient- and procedure-related factors. These measures include anticoagulation with low molecular weight heparin and the use of mechanical compression devices.

scholarly journals 926 Evaluating VTE Prophylaxis in Nephrectomy in Two Merseyside Hospitals

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
T Farmer ◽  
A Calmuc ◽  
K Wong ◽  
B Starmer ◽  
S Venugopal
Keyword(s):  
Venous Thromboembolism ◽  
University Hospital ◽  
Prescribing Practices ◽  
Local Data ◽  
Vte Prophylaxis ◽  
European Guidelines ◽  
Prescribing Practice ◽  
Open Nephrectomy ◽  
Review Current ◽  
Park Hospital

Abstract Aim The primary aim was to review current venous thromboembolism (VTE) prophylaxis prescribing against national and European guidelines at two hospitals in northwest England. A secondary aim was to standardise VTE prescribing practices. Method 3 standards were identified (NICE, BAUS and EUA) for VTE prophylaxis in nephrectomy. All simple and radical nephrectomies and nephroureterectomies were included. Open and laparoscopic cases were included. Data was collected from Royal Liverpool University Hospital (RLUH) and Arrowe Park Hospital (APH). Cases from surgical diaries between January 2019 to January 2020 were identified and compared to the 3 standards. 49 cases were identified at RLUH and 83 at APH Results At APH, 77/83 (92.7%) cases received inpatient LMWH. The remaining 6 were already on a DOAC. 98.7% received inpatient mechanical VTE prophylaxis. 85.5% of patients received extended VTE prophylaxis with no documented indication, and only 20% of open nephrectomies received 28 days LMWH. At RLUH 44/49 cases (89.7%) received inpatient LMWH. All 5 patients who did not had a documented reason why. 100% of inpatients at received inpatient mechanical VTE prophylaxis. 4 patients underwent open nephrectomy, however none of these received 28-day extended LMWH prophylaxis. Conclusions Comparing guidelines with local data reveals that prescribing practice for both in- and outpatient LMWH is variable and often is based on personal preferences. The above results have been presented locally at each institution and practice standardised with re-audit ongoing.

scholarly journals Survey of Perceptions and Practices among Canadian Gastroenterologists regarding the Prevention of Venous Thromboembolism for Hospitalized Inflammatory Bowel Disease Patients

2012 ◽  
Vol 26 (11) ◽  
pp. 795-798 ◽  
Author(s):  
Roshan Razik ◽  
Charles N Bernstein ◽  
Justina Sam ◽  
Reka Thanabalan ◽  
Geoffrey C Nguyen
Keyword(s):  
Inflammatory Bowel Disease ◽  
Venous Thromboembolism ◽  
Bowel Disease ◽  
Demographic Data ◽  
Pharmacological Prophylaxis ◽  
Vte Prophylaxis ◽  
Clinical Scenarios ◽  
Increased Risk ◽  
Inflammatory Bowel ◽  
Preventable Complication

BACKGROUND: Patients with inflammatory bowel disease (IBD) who are hospitalized with disease flares are known to be at an increased risk of venous thromboembolism (VTE). This is a preventable complication; however, there is currently no standardized approach to the prevention and management of VTE.OBJECTIVES: To characterize the opinions and general prophylaxis patterns of Canadian gastroenterologists and IBD experts.METHODS: A survey questionnaire was sent to Canadian gastroenterologists affiliated with a medical school or IBD referral centre. Participants were required to be practicing physicians who had completed all of their training and had been involved in the care of IBD patients within the previous 12 months. Various clinical scenarios were presented and demographic data were solicited.RESULTS: The majority of respondents were practicing in an academic setting (95%) and considered themselves to be IBD experts or subspecialists (71%). Eighty-three per cent reported providing VTE prophylaxis most, if not all of the time, and most (96%) used pharmacological prophylaxis alone, usually heparin or one of its analogues. There was less consistency among respondents with respect to whether IBD patients in remission, but admitted for another condition, should be given prophylaxis. There was also less agreement regarding the duration of anticoagulation in patients with confirmed VTE.CONCLUSION: There was a general consensus among academic gastroenterologists that IBD inpatients are at an increased risk for VTE and would benefit from VTE prophylaxis. However, areas of uncertainty still exist and the IBD community would benefit from evidence-based clinical practice guidelines to standardize the management of this important problem.

Venous thromboembolism in a general hospital. An update with low molecular weight heparin prophylaxis

VASA ◽  
2007 ◽  
Vol 36 (1) ◽  
pp. 17-22
Author(s):  
Schulz ◽  
Kesselring ◽  
Seeberger ◽  
Andresen
Keyword(s):  
Molecular Weight ◽  
Pulmonary Embolism ◽  
Venous Thromboembolism ◽  
Low Molecular Weight ◽  
Trauma Patients ◽  
Vte Prophylaxis ◽  
Vein Thrombosis ◽  
Patients At Risk ◽  
Hospital Stays ◽  
Event Rates

Background: Patients admitted to hospital for surgery or acute medical illnesses have a high risk for venous thromboembolism (VTE). Today’s widespread use of low molecular weight heparins (LMWH) for VTE prophylaxis is supposed to have reduced VTE rates substantially. However, data concerning the overall effectiveness of LMWH prophylaxis is sparse. Patients and methods: We prospectively studied all patients with symptomatic and objectively confirmed VTE seen in our hospital over a three year period. Event rates in different wards were analysed and compared. VTE prophylaxis with Enoxaparin was given to all patients at risk during their hospital stay. Results: A total of 50 464 inpatients were treated during the study period. 461 examinations were carried out for symptoms suggestive of VTE and yielded 89 positive results in 85 patients. Seventy eight patients were found to have deep vein thrombosis, 7 had pulmonary embolism, and 4 had both deep venous thrombosis and pulmonary embolism. The overall in hospital VTE event rate was 0.17%. The rate decreased during the study period from 0.22 in year one to 0,16 in year two and 0.13 % in year three. It ranged highest in neurologic and trauma patients (0.32%) and lowest (0.08%) in gynecology-obstetrics. Conclusions: With a simple and strictly applied regimen of prophylaxis with LMWH the overall rate of symptomatic VTE was very low in our hospitalized patients. Beside LMWH prophylaxis, shortening hospital stays and substantial improvements in surgical and anasthesia techniques achieved during the last decades probably play an essential role in decreasing VTE rates.

IMPLEMENTASI CONTEXTUAL TEACHING-LEARNING MELALUI RISET MINI DALAM PERKULIAHAN PENELITIAN PENGAJARAN UNTUK MENINGKATKAN KOMPETENSI MAHASISWA JURUSAN PENDIDIKAN TEKNIK ELEKTRO MEMBANGUN PROPOSAL PENELITIAN

2013 ◽  
Vol 6 (2) ◽  
Author(s):  
Hamonangan Tambunan
Keyword(s):  
Education Research ◽  
Action Research ◽  
Research Method ◽  
Research Proposal ◽  
Education Department ◽  
Building Research ◽  
The Third ◽  
Fourth Cycle ◽  
Contextual Teaching ◽  
Teaching Learning

Abstrak: Penelitian ini dilakukan melalui penelitian tindakan kelas dengan melibatkan subjek sebanyak 39 orang mahasiswa jurusan Pendidikan Tenik Elektro Fakultas Teknik Unimed, menyangkut permasalahahan implementasi contextual teaching-learning melalui riset mini dalam perkuliahan metode penelitian pengajaran. Masalahnya adalah apakah implementasi kontekstual teaching learning melalui riset mini dapat meningkatkan kompetensi mahasiswa dalam membangun proposal penelitian?. Penelitian dilakukan dalam 5 siklus dengan target capaian yaitu 85% mahasiswa mencapai skor ≥ 80. Hasil yang diperoleh yaitu ada peningkatan dari siklus ke siklus berikutnya, yaitu pada siklus I ada 12 orang mahasiswa (30,76%) mencapai target; pada siklus II ada 19 orang   mahasiswa (48,71%) mencapai target; Pada siklus III ada 24 orang mahasiswa (61,53%) mencapai target; Pada siklus IV terdapat sejumlah 28 orang mahasiswa (71,79%) yang mencapai target; dan pada siklus V terdapat 34 orang mahasiswa (87,17%) sudah mencapai target. Berdasarkan temuan penelitian disimpulkan bahwa implementasi contextual teaching learning melalui riset mini dapat meningkatkan kompetensi mahasiswa dalam membangun proposal penelitian.   Kata Kunci: Implementasi kontekstual teaching learning   Abstract: The research was conducted through action research involving subjects as many as 39 students of electrical education department of  technical faculty Unimed, concerning the problems of contextual teaching learning implementation through mini rsearch in education research method course. The formulation of this researh problem is “whether the implementation of contextual teaching learning through mini research can improve students' competencies in building research proposal?. The study was conducted in 5 cycles with a target achievement of 85% of students achieving a score of ≥ 80. The results are an increase of the cycle to the next cycle, the first cycle, there were 12 students (30.76%) targets; in the second cycle there are 19 students (48.71%) targets; In the third cycle there were 24 students (61.53%) targets; in the fourth cycle there are a number of 28 students (71.79%) to reach the target, and the cycle of V contained 34 students (87.17%) has reached the target. Based on the findings of the study concluded that the implementation of contextual teaching learning through mini research can improve the competence of students in developing research proposals.   Keywords: Contextual teaching learning implementation

scholarly journals The risk of venous thromboembolism and physical activity level, especially high level: a systematic review

2021 ◽  
Author(s):  
H. Danin-Mankowitz ◽  
A. Ugarph-Morawski ◽  
F. Braunschweig ◽  
P. Wändell
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Venous Thromboembolism ◽  
Activity Level ◽  
Case Control Studies ◽  
The Third ◽  
Area Of Interest ◽  
High Level ◽  
The Relationship

AbstractVenous thromboembolism (VTE) is the third most common cause of cardiovascular disease. Connection between high level of physical activity (PA) and the onset of VTE is unknown. We searched the literature on the possible association between PA level, especially high levels, and the risk of VTE. A systematic review was carried out to identify relevant articles on the relation between PA level and VTE. The initial search was conducted together with the Karolinska Institutet University Library in February 2018, with follow-up searches after that. In total, 4383 records were found and then screened for exclusion of duplicates and articles outside the area of interest. In total, 16 articles with data on 3 or more levels of PA were included. Of these, 12 were cohort and 4 were case-control studies. Totally 13 studies aimed at investigating VTE cases primarily, while three studies had other primary outcomes. Of the 16 studies, five found a U-shaped association between PA level and VTE risk, although non-significant in three of them. Two articles described an association between a more intense physical activity and a higher risk of VTE, which was significant in one. Nine studies found associations between increasing PA levels and a decreasing VTE risk. Available literature provides diverging results as to the association between high levels of PA and the risk of venous thromboembolism, but with several studies showing an association. Further research is warranted to clarify the relationship between high level PA and VTE.

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