Educational campaign to improve the prevention of postoperative venous thromboembolism

Background: Recent studies have revealed considerable scope for improvement in preventing postoperative venous thromboembolism. This project comprised a baseline assessment of the use of preventive measures within the Royal H obart Hospital, followed by the implementation and evaluation of an educati onal program directed at hospital staff. Aim: To determine whether the Royal Hobart Hospital's guidelines for the pr ophylaxis of postoperative venous thromboembolism were being utilized effec tively and, if necessary, attempt to improve use of the guidelines through an educational programme. Methods: Data were collected retrospectively from the medical records of 25 0 surgical patients undergoing a procedure during February 1997. Patients w ere classified as being at a low, medium or high risk of venous thromboembo lism using two sets of criteria. The percentage of patients receiving the a ppropriate prophylaxis was determined. An educational programme to promote the hospital's guidelines for the prophylaxis of postoperative venous throm boembolism was then implemented. Included were presentations to staff, post ers placed throughout the hospital and the wide distribution of the results and a glossy card showing the hospital's guidelines. Follow-up data were s ubsequently collected from another 250 surgical patients. Results: Only 59% of patients received appropriate prophylaxis according to the hospital's approved guidelines, with little change when those patients with possible contraindications to thromboprophylaxis were excluded. When those patients at a high risk of venous thromboembolism were examined, only 25% were prescribed the recommended preventive measures. There was no diff erence between elective versus emergency surgery and the use of appropriate prophylaxis. Following the implementation of the educational programme, da ta collection from another 250 surgical patients revealed a significant inc rease (P < 0.05 by chi-square test) in the level of appropriate thromboprop hylaxis to 70% of patients, with 77% of the high-risk patients being prescr ibed the recommended preventive measures. Conclusions: A pharmacy-based educational intervention significantly improv ed adherence to the hospital's guidelines for the prophylaxis of postoperat ive venous thromboembolism.