Audit of Compliance with Pharmacological Prophylaxis of Venous Thromboembolism in an Internal Medicine Department
DOI:
https://doi.org/10.24950/rspmi/original/163/1/2018Keywords:
Hospitalization, Risk Assessment, Venous Thromboembolism/prevention & controlAbstract
Introduction: Venous thromboembolism (VTE) is the first
cause of preventable intra-hospital death. The goal of this
study was to evaluate the compliance of pharmacological prophylaxis of VTE in an Internal Medicine Department
(IMD). This evaluation was based on a VTE risk assessment
guide that was established as quality indicator.
Material and Methods: Observational cross-sectional study
between 2010 and 2016. The patients admitted to IMD on
the first Friday of each month were included and hypocoagulated or absent patients on the third day of hospitalization
were excluded. VTE risk assessment registry and prescription of prophylaxis on admission (D0) and on the third day
(D3) were monitored. Adequacy rate of VTE prophylaxis (ratio between the number of patients undergoing appropriate
prophylaxis and the total number of patients included) was
calculated annually in D0 and D3.
Results: A total of 569 patients were selected and 149 were
excluded. Of the 420 patients included, 403 were considered
at risk. Of these, 93.3% had a risk assessment registered in
the clinical process at admission. Fifty-four patients had a
contraindication for pharmacological prophylaxis. Of the 349
patients eligible for prophylaxis, 86.8% had adequate prescription on admission. There were few prescribing errors. In
D0 the adequacy rate of pharmacological prophylaxis was
88.1% and in D3 87.6%.
Conclusion: The risk assessment registry is widespread in
IMD with a very considerable high percentage of pharmacological prophylaxis adequacy. The establishment of clinical
guides and their systematic auditing allow a better understanding of reality and increase good practice, improving
health organization.
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