Photo courtesy of the CDC
In a single-center study, researchers found that educating healthcare providers about the need for venous thromboembolism (VTE) prophylaxis did not ensure that patients received appropriate treatment.
Before the educational program was introduced, 36% of patients who were at risk of VTE were not receiving VTE prophylaxis. After the program, 26% of at-risk patients were not receiving prophylaxis.
The researchers reported these findings in the Canadian Journal of Cardiology.
The team carried out chart reviews of patients in a university-affiliated, tertiary care cardiology center, which included a clinical teaching unit and a coronary care unit.
Audits were conducted 3 and 5 months before the introduction of an educational program on VTE prophylaxis protocol, followed by a second series of audits 3 and 5 months after protocol initiation.
In each set of audits, conducted over 2 months, 3 independent groups consisting of a physician and a nonphysician healthcare provider (nursing, pharmacy) each reviewed the data. Discrepancies were settled by the senior investigators.
In the first set of audits, 173 charts for patients considered at high risk for VTE were evaluated. The second set of audits included 247 patients.
Prior to the educational program, including a guideline-based protocol, 36% of all patients who were considered at risk for VTE did not receive prophylaxis.
Three months after the program was initiated, 21% of patients were still not being treated according to the recommended guidelines, and that percentage rose to 28% at 5 months post-protocol.
“Awareness and education surrounding VTE prophylaxis is challenging in the inpatient teaching unit model due to a number of factors, including the high turnover of senior and junior physicians as well as nursing staff,” said study author Colette Seifer, of the University of Manitoba in Winnipeg, Manitoba, Canada.
“A single time point intervention is unlikely to result in a sustained improvement in VTE prophylaxis rates.”
However, Seifer and her colleagues believe that automated alerts and checklists incorporated into electronic patient records or used via innovative software programs have the potential to improve compliance rates.
