The Standardization of Venous Thromboembolism (VTE) Prophylaxis in Hospitalized Patients and Increase of Physicians' Adherence to Use VTE Prophylaxis in Anadolu Medical Center

Abstract

PURPOSE: The aim of the project is to prevent VTE, improve patient safety and increase of physicians' adherence to use VTE prophylaxis. METHODS: Since January 2011, physicians have been requested to follow a protocol where they assess hospitalized patients (except pediatric or anticoagulated patients) with a standardized electronic risk assessment form (eRAF) which guides physicians to choose an appropriate prophylaxis regimen based on the risk stratification within the first 24 hours of admission to the hospital. The VTE prophylaxis data have been analyzed every 3 months, feedback was given to physicians individually and adherence rate to VTE prophylaxis protocol was defined as a performance criteria. RESULTS: 2265 patients in 2011, 2492 patients in 2012 were assessed for VTE risks. Patients' distribution for low (I), medium (II), high (III), very high (IV) and undefined (V) risk groups were 2%, 20%, 40%, 36% and 2% respectively for 2011 and 21%, 20%, 38%,18% and 2% respectively for 2012. The adherence rates to VTE prophylaxis protocol for low, medium, high, very high risk groups were 51%, 67%, 47%, 41% respectively for 2011 and 79%, 81%, 71% and 87% respectively for 2012. Undefined risk group were assumed to have an inappropriate treatment. Total adherence rates for VTE prophylaxis protocol were 48% for 2011 and 76% for 2012. In 2011 there was 1 VTE patients with insufficient prophylaxis. In 2012 there were 4 VTE patients (2 patients in very high risk group,1 in high risk group, 1 in moderate risk group) all of them with appropriate treatment. There was not any life threatening bleeding complication and any VTE mortality in 2011 and 2012. CONCLUSIONS: eRAF can be used to standardize VTE prophylaxis and helps to increase physicians' adherence to use VTE prophylaxis. EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS) hospital patient human prophylaxis protocol compliance standardization venous thromboembolism EMTREE MEDICAL INDEX TERMS bleeding feedback system high risk population hospital mortality patient patient safety physician risk risk assessment stratification