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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.
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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
Audit of VTE currently being undertaken by the Trust • 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
VTE risk assessment • 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
Clinical incident and Pharmacy intervention reporting • 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
Healthcare records audit • 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
Root cause analysis of hospital acquired thrombosis • Hospital acquired thrombosis detected by DVT/Anticoagulant clinic Coding Diagnostics Autopsies • Subjected to a root cause analysis • Reviewed by the Thrombosis committee
Rivaroxabanthromboprophylaxis following elective THR and TKR • 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
Number of patients prescribed dalteparin in place of rivaroxaban