Abstract Number: PB2386
Meeting: ISTH 2020 Congress
Background: This clinical audit consists in an assessment of medical practices at Santa Casa de Misericórdia in Belo Horizonte (SCMBH) regarding the use of thromboprophylaxis in patients hospitalized at Internal Medicine Departament.
Aims: The objective is to evaluate the quality of the service provided and compare it with the ideal assistance. This is a third audit on the same topic that evaluates the impact of the measures suggested by the previous studies and electronic protocol implementation.
Methods: This is a retrospective and observational study whose data were obtained from the electronic records available at SCMBH between August and December 2019. Ninety patients were randomly selected admitted to clinical wards evaluating risk of thromboembolism and bleeding, as well as the prescription of thromboprophylaxis The risk assessment of VTE was based on the PADUA score (score greater than or equal to 4: considered high. The risk of Bleeding was assessed using IMPROVE score and was defined as high risk score greater than or equal to 7. The data collected were processed and compared with other audits.The recommendations were made using the GRADE methodology (The Grading of Recommendations Assessment, Development and Evaluation).
Results: There is an important increase in numbers, revealing that there was an positive impact in the implementation of the PADUA and IMPROVE scores in record. About correct use of thromboprophylaxis: There was a decrease in prescription misuse of medication and increased adherence and correct use of thromboprophilaxis with mandatory filling in the electronic medical chart.
Conclusions: We verified that the implementation of the mandatory questionnaire at admission had a strong positive impact implementing adequate thromboprophylaxis in patients admitted at SCMBH and reduced the iatrogenic use of heparins. The audit supports the importance of spreading the risk assessment routine in the service, maintaining the institutional protocol and also the importance of Electronic Chart and Protocol implementation.
To cite this abstract in AMA style:Fernandes do Carmo Las Casas PH, Machado Veloso JE, Coelho Cavalcante D, Fernandes Nogueira M, Ferreira de Brita AL, Aredes Lima M, Gorle de Miranda Chaves A, Barbosa Lana FC, Almeida Pessoa I. Thromboprophylaxis Audit in a Public Hospital – The Impact of Protocol Implementation [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/thromboprophylaxis-audit-in-a-public-hospital-the-impact-of-protocol-implementation/. Accessed February 28, 2024.
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