BACKGROUND: Venous thromboembolic disease (VTED) prophylaxis is a key strategy in reducing preventable deaths in medical inpatients. We assessed compliance with internationally published guidelines for VTED prophylaxis in at-risk medical patients before and 1 month after an educational intervention to enhance compliance with such guidelines. RESULTS: One hundred and fifty patients were assessed on each occasion. Pre-intervention, VTED prophylaxis was prescribed in only 48% of at-risk cases. Compliance was best among patients under stroke services and worst for those under acute medical teams. Patients within specialist units were more likely to be prescribed prophylaxis than those in general wards (75 vs. 53%; p = 0.0019). Post-intervention, overall compliance improved to 63% (p = 0.041 for comparison). There was a significant improvement among general medical teams (48 vs. 75%; p = 0.001), and in general wards (52 vs. 74%; p = 0.003). CONCLUSIONS: Thromboprophylaxis is under-prescribed in medical inpatients, but compliance with international guidelines can be significantly enhanced with targeted educational intervention.
BACKGROUND:Venous thromboembolic disease (VTED) prophylaxis is a key strategy in reducing preventable deaths in medical inpatients. We assessed compliance with internationally published guidelines for VTED prophylaxis in at-risk medical patients before and 1 month after an educational intervention to enhance compliance with such guidelines. RESULTS: One hundred and fifty patients were assessed on each occasion. Pre-intervention, VTED prophylaxis was prescribed in only 48% of at-risk cases. Compliance was best among patients under stroke services and worst for those under acute medical teams. Patients within specialist units were more likely to be prescribed prophylaxis than those in general wards (75 vs. 53%; p = 0.0019). Post-intervention, overall compliance improved to 63% (p = 0.041 for comparison). There was a significant improvement among general medical teams (48 vs. 75%; p = 0.001), and in general wards (52 vs. 74%; p = 0.003). CONCLUSIONS: Thromboprophylaxis is under-prescribed in medical inpatients, but compliance with international guidelines can be significantly enhanced with targeted educational intervention.
Authors: Alexander T Cohen; Raza Alikhan; Juan I Arcelus; Jean-François Bergmann; Sylvia Haas; Geno J Merli; Alex C Spyropoulos; Victor F Tapson; Alexander G G Turpie Journal: Thromb Haemost Date: 2005-10 Impact factor: 5.249
Authors: Nils Kucher; Sophia Koo; Rene Quiroz; Joshua M Cooper; Marilyn D Paterno; Boris Soukonnikov; Samuel Z Goldhaber Journal: N Engl J Med Date: 2005-03-10 Impact factor: 91.245
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Authors: David G Sherman; Gregory W Albers; Christopher Bladin; Cesare Fieschi; Alberto A Gabbai; Carlos S Kase; William O'Riordan; Graham F Pineo Journal: Lancet Date: 2007-04-21 Impact factor: 79.321