VTE risk assessment and management in admitted patients at a private hospital in Dubai- A quality improvement project.

backgroundGlobally, an estimated 10 million VTE episodes are diagnosed each year; over half of these episodes are associated with hospital inpatient stays and result in significant loss of disability-adjusted life years. According to NICE guidelines, all patients should undergo an initial risk assessment, followed by a reassessment 24 h later. Non-compliance with VTE risk assessment and management can cause extended length of stay, heightened morbidity, and increased mortality rates amongst the admitted patients. This study aims to determine the current VTE practices to reduce hospital-acquired thrombosis and standardize the practice of VTE management through a quality improvement project.

methodsA retrospective chart review was conducted to see the compliance of the VTE risk assessment and management of VTE in patients admitted to the King’s College Hospital London, Dubai. All adult male and female patients admitted to the hospital between August 2022 and March 2023 were included. A purposive sampling technique was used to collect the data. A total of 734 patients were included in the study. Mean and SD were calculated for the quantitative variables, and frequency and percentages were calculated for the categorical variables. Bar graphs were developed to visually display the data.

resultsThe mean ± SD age was 46.15 ± 15.81 years. Of the 734 patients, the majority were medical patients. All patients underwent VTE risk assessment, and for almost all it was completed within 24 h (n = 733, 99.86%). Nearly half of the patients were at high risk of VTE (n = 299, 40.74%). One-third of the patients, 28.88% (n = 212), were prescribed pharmacological prophylaxis. No patient-acquired thrombosis in the hospital (0.0%). No VTE prophylaxis was initiated for mobilized high-risk VTE patients, 3.13% (n = 23). Average length of stay was 2 days (IQR: 1–5) in patients who didn’t receive the prophylaxis (p = 0.001). None of the patients had bleeding who received pharmacological prophylaxis. No hospital acquired thrombosis in any medical or surgical patients.

conclusionThis study demonstrates a significant improvement in VTE risk assessment compliance in patients. This study also identified the appropriate prophylaxis prescribed and given to patients either pharmacological, mechanical or both. However, the study identified gaps in practices of prophylaxis in patients who are at high risk of bleeding and are mobilized. Continuous education and training of healthcare providers are crucial to ensure appropriate prophylaxis is administered to high-risk patients.