In order to gain insight into appropriate thromboprophylaxis use across Canada for patients at risk of VTE, Canadian Venous Thromboembolism (VTE) Audit Day was held Monday, April 10, 2013. Some 118 healthcare sites participated from coast to coast, with data collected from 4,667 patients in general internal medicine (64 per cent) and general surgery (31 per cent).
“The audit results were encouraging in that 81 per cent of patients received the appropriate thromboprophylaxis; however there is room for improvement since 19 per cent of patients at risk for VTE did not receive appropriate thromboprophylaxis,” says Dr. Bill Geerts, National VTE Prophylaxis Lead for Safer Healthcare Now! “The audit provides a snapshot of how we were doing nationally on the day that data was collected and reinforces that we need to continue to make a commitment to our patients to prevent hospital-acquired VTE. Overall, 79 per cent of general medical patients and 84 per cent of general surgery patients received appropriate thromboprophylaxis.”
Of particular interest was that when preprinted order sets are used, 91 per cent of patients received the appropriate thromboprophylaxis, compared to only 71 percent when the orders were hand written. Preprinted order sets were used in 57 per cent of general medicine and 51 per cent of general surgery audited.
While the results varied by province and by region, the type of prophylaxis used most often (for 90 per cent of patients) was a Low Molecular Weight Heparin (dalteparin, enoxaparin, nadroparin, tinzaparin, or fondaparinux) or low dose Heparin. Only four per cent or patients received mechanical prophylaxis. Among the at-risk patients who were not receiving appropriate thromboprophylaxis, 70 per cent were not receiving any thromboprophylaxis. Other reasons included administering the wrong dose, delay in starting and insufficient duration.
“The audit is a valuable tool to monitor prophylaxis use and many organizations indicated that they would continue to use the data collection tool to measure their results and progress in quality improvement,” added Dr. Geerts. “From a national perspective, the audit highlighted some gaps in knowledge and areas that we can address in further education efforts and future National Calls.”
The VTE Data Collection Tool is available for organizations to access from CPSI’s Patient Safety Metrics. At www.patientsafetymetrics.ca This tool utilizes optical mark recognition (OMR) technology allowing users to complete the audit on paper, fax the results, and have the result automatically uploaded into the Patient Safety Metrics System for reporting and analysis.
A National Call took place on May 21st to review the audit results which were compiled and analyzed by the Safer Healthcare Now! Central Measurement Team.
To access results of the audit visit http://www.slideshare.net/PatientSafetyCanada/vte-audit-day-20130521 or to learn more about VTE Audit Day, visit www.saferhealthcarenow.ca
To learn more about Patient Safety Metrics or the VTE Data Collection Tool contact the Central Measurement Team at firstname.lastname@example.org, or call 416-946-3103.
An initiative of the Canadian Patient Safety Institute, National VTE Audit Day was endorsed by Accreditation Canada, BC Patient Safety and Quality Council, Manitoba Institute for Patient Safety, Ontario Hospital Association, The Ottawa Hospital, Saskatchewan Ministry of Health and the Nova Scotia Ministry of Health and Wellness.