audit in vte prevention
DESCRIPTION
Audit in VTE prevention. Peter Davies Senior Pharmacist. Drivers for audit. Venous thromboembolic prevention is a DH patient safety priority NICE clinical guideline venous thromboembolism reducing the risk CQUIN The NHS standard contract for acute services and VTE prevention. - PowerPoint PPT PresentationTRANSCRIPT
Peter DaviesSenior Pharmacist
Venous thromboembolic prevention is a DH patient safety priority
NICE clinical guideline venous thromboembolism reducing the risk
CQUIN
The NHS standard contract for acute services and VTE prevention
VTE risk assessment audit
Clinical incident/Pharmacy intervention monitoring
Healthcare record audit
Root cause analysis of hospital acquired thrombosis
Rivaroxaban use in elective THR and TKR
Audit data since June 2008
Data collected from the front of the drug administration and record chart
3 monthly data until May 2010 now monthly
CQUIN requirements
Reporting forms adapted to include fields to record incidents and interventions relating to VTE prevention and prophylaxis
Report generated by clinical risk and sent monthly to the thrombosis committee
Data provided by individual wards
Audit of 5 sets of healthcare records
Record data on whether risk assessment and thromboprophylaxis is appropriate on an electronic data collection form
Data collated by clinical audit and forwarded to the Thrombosis committee
Hospital acquired thrombosis detected by
DVT/Anticoagulant clinic Coding Diagnostics Autopsies
Subjected to a root cause analysis
Reviewed by the Thrombosis committee
For elective Primary THR or TKR
First dose 30 hours post surgery
14 days for TKR and 35 days for THR
Contra-indicated e-GFR <30ml/min
Not used if on long term anticoagulant
Documented bleeding episodes resulting in rivaroxaban being stopped/omitted
Number ofepisodes
Wound oozing/bleeding 4
GI bleed 2
Haematuria in catheterised patient 1
Bleed from drain 2
Off-label use of rivaroxaban Number of
patients
Revision of TKR 3
Revision of THR 3
Patella resurfacing 2
Hip resurfacing 2
Uni-compartment knee replacement 2
Fractured neck of Femur leading to THR 1