|Title:||Stop The Clot: Improving VTE prophylaxis prescription among patients admitted to hospital with COVID 19: a quality improvement project.|
|Author(s):||M Calvo-Gurry P Kerr C Sheil A Worrall M Rowland M Lavin E deBarra R Morgan D Ryan|
|Poster:||Click to view poster|
|Abstract:||Over the course of the COVID pandemic, evidence evolved that began to demonstrate that COVID19 was a significant risk factor for the development of venous thromboembolism (VTE). Prescription of thromboprophylaxis is now accepted practice.|
Our aim was to increase the number of patients receiving appropriate VTE prophylaxis in patients admitted to Beaumont Hospital with COVID19 related illness treatment.
An initial point-prevalence audit of 30 retrospective patients and 70 current inpatients was felt to be representative. Combined retrospective and prospective approaches were used to evaluate for an evolution in practice as more evidence of COVID-related VTE emerged. Weight, LMWH dose, CrCl, presence of an indication for therapeutic anticoagulation/contraindication to prophylactic anticoagulation was recorded. Patient data was anonymised at time of collection.
We found that thromboprophylaxis prescription was well below the acceptable level in our hospital during the initial study period. We found that at baseline, 53% of patients received appropriate VTE prophylaxis.
We performed three cycles of audit/QI to improve practice locally. We instituted an educational itnervention, a novel poster and infographic concept and developed an area of excellence for COVID care.
Prescription of thromboprophylaxis improved to 100 % following our interventions.
We found that although all doctors understand the importance of VTE prophylaxis, it can be overlooked due to many factors. We identified this was being overlooked early in the pandemic and took a multi-modal approach to improvement. Improvement in practice due to interventions were excellent, as the motivation for change and improvement among all staff grades was very high.
Limitations to this project are that COVID19 had our full attention and significant resources. This will not always be the case.
In conclusion, our quality improvement project successfully contributed to the improved prescription of thromboprophylaxis locally during the first wave of the COVID-19 pandemic.