GETTING A VALIDATED GUIDELINE INTO LOCAL PRACTICE - IMPLEMENTATION AND AUDIT OF THE SIGN GUIDELINE ON THE PREVENTION OF DEEP-VEIN THROMBOSIS IN A DISTRICT GENERAL-HOSPITAL

This paper describes the implementation of a specific clinical guideli ne on venous thromboprophylaxis and outlines the audit design and meth ods used to achieve this objective. A member of the clinical staff was seconded to oversee this implementation and co-ordinate audit of curr ent practice in the main clinical specialties within the trust. The Tr ust Clinical Audit Committee agreed to fund this low cost initiative ( approximately pound 3,800) from clinical guideline monies. Findings fr om the initial audit revealed a total of 224 patients identified as 'a t risk' of developing deep vein thrombosis or pulmonary embolism. Of t his number 72.8%, (n=163), were prescribed prophylaxis compared with t he pre-set standard of 90.0%. Fifty four percent, (n=122), of all iden tified patients were prescribed the correct prophylaxis in accordance with SIGN guideline recommendations. As a result of the initial findin gs local prevention protocols were developed or upgraded as required i n line with the national guideline. The repeat audit findings highligh ted a significant increase in the number of 'at risk' patients prescri bed prophylaxis rising from 72.8% to 97.4% (P<0.001) and similarly fro m 54.5% to 95.9% for those prescribed the correct prophylaxis (P<0.001 ).