Abstract Number: PB1201
Meeting: ISTH 2021 Congress
Background: In 2010, a national Venous Thromboembolism (VTE) Prevention Programme was introduced in England to prevent hospital associated VTE (HA-VTE). Mandatory documented risk assessment for VTE on hospital admission underpinned implementation, supported by NICE guidance on thromboprophylaxis. VTE risk assessment rates remain high nationally, but there is little data on thromboprophylaxis use and the impact on HA-VTE. A national survey of VTE prevention practice and rates of HA-VTE was undertaken through Getting It Right First Time (GIRFT); a national quality improvement initiative aimed at reducing unwarranted variation in clinical practice.
- To survey appropriate use of thromboprophylaxis and supply of patient information on VTE during hospitalisation.
- To estimate rates of HA-VTE and proportion that were potentially preventable events.
Methods: Three thromboprophylaxis surveys were distributed to all NHS England hospitals with data required from October 2019 to March 2020 & collected centrally. They assessed 1. organisational resource, 2. Rates of thromboprophylaxis and information provision to patients at high risk of VTE (n=20 per site/month), and 3. Details of HA-VTE.
Results: 98 hospitals (68% of 144 invited) participated in ≥1 survey. 98 hospitals contributed data regarding 9553 patients to survey 2. Written patient information was provided to 2859 (31%; variation 0-100%). Anticoagulant thromboprophylaxis was prescribed to 6544 (88%, of 7399 with an indication) with significant inter-hospital variation (40-100%). Missed doses were common (8.1%; variation 0-55%).
84 hospitals submitted 4595 HA-VTE cases, of which 595 (13%, variation 0-100%) were considered potentially preventable. The median rate of HA-VTE was 1.89 per 1000 admissions (IQR 0.61 – 3.17) with variation by admission type; medical 4.0 (1.6-7.9), surgical 1.4 (0.67-2.3) and obstetric 0.84 (0.53-1.3) per 1000 admissions.
Conclusions: There remains significant variation in VTE prevention care throughout NHS England. Provision of patient information and ensuring anticoagulant prophylaxis is given are key areas for improvement.
To cite this abstract in AMA style:Roberts LN, De Caro M, Ridgeon A-, Moroy C, Briggs T, J Hunt B, Arya R. National Survey of Hospital–associated Venous Thromboembolism Prevention in NHS England: Findings from the GIRFT Thrombosis Survey [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/national-survey-of-hospital-associated-venous-thromboembolism-prevention-in-nhs-england-findings-from-the-girft-thrombosis-survey/. Accessed December 11, 2023.
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