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Three cycle Audit on Venous Thromboembolism Prophylaxis for General Surgery Admissions at a busy DGH, Audit, General Surgery.

Kimberley Davies, Mahul Patel, Eunkyung Lee, Ruslan Ustinov, Rachel Eigbefoh, Nour Ayoub, Firas Alkistawi, Joshi Sanjay
Medway Maritime Hospital, Gillingham, United Kingdom


A three cycle audit on venous thromboembolism prophylaxis was undertaken from general surgical admissions at a district general hospital.


Introduction: Approximately 25,000 mortalities occur annually in the UK arising from complications due to venous thromboembolism. This costs the NHS approximately £200 million. 2021 NICE guidelines regarding VTE prophylaxis states that every patient should be assessed for risk either at admission or by the first consultant review. If prophylaxis is indicated guidelines state treatment should be initiated within 14 hours of admission. This study aimed to assess the compliance of this surgical department within national guidelines.


Results: The initial audit revealed poor adherence to national guidelines. Only 78%of VTE assessments were completed on admission. Following implementation of EPR this increased to 100% over 2nd and 3rd cycles.
Fragmin was prescribed in 80% of the patients during the 1st cycle, halving to 40% over the 2nd cycle. This increased to 65% in the 3rd cycle following education. TED stockings were prescribed for 48% of patients in the 1st cycle, 25% in 2nd cycle and then 50% in 3rd cycle.


Conclusion: The study demonstrated that the department failed to meet national guidelines on VTE prophylaxis in the 1st cycle of the audit. Following EPR the department was able to meet the guidelines for assessment of patients for VTE prophylaxis. It appears the rates of prescribing mechanical and chemical prophylaxis fell due to inadequate teaching for prescribers using EPR, this had been addressed prior to the 3rd cycle.