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Venous thromboembolism in over 16s: reducing the risk of hospital-acquired deep vein thrombosis or pulmonary embolism [NG89]

Measuring the use of this guidance

Recommendation: 1.1.1

Assess all patients to identify the risk of venous thromboembolism (VTE) and bleeding (see recommendation 1.1.2 for all medical patients, 1.1.5 for all surgical patients, 1.1.9 for all pregnant women and all women who gave birth or had a miscarriage or termination of pregnancy in the past 6 weeks, 1.8.1 for all people admitted to the critical care unit and 1.9.1 for all acute psychiatric patients).

What was measured: Proportion of reported patients in an acute setting on May 31 who were being treated for venous thromboembolism, where treatment started after admission.
Data collection end: May 2015
0.59%
Data collection end: May 2016
0.53%
Data collection end: May 2017
0.56%
Data collection end: May 2018
0.66%
Data collection end: May 2019
0.59%
Area covered: England
Source: NHS Safety Thermometer: Classic

What was measured: Proportion of adult hospital admissions assessed for risk of VTE on admission.
Data collection end: March 2014
96%
Number that met the criteria: 3403863 / 3545837
Data collection end: March 2015
96%
Number that met the criteria: 3423555 / 3566055
Data collection end: March 2016
95.5%
Number that met the criteria: 3509040 / 3673143
Data collection end: March 2017
95.7%
Number that met the criteria: 3550118 / 3708198
Data collection end: March 2018
95.2%
Number that met the criteria: 3515473 / 3692479
Area covered: England
Source: VTE Risk Assessment Data Collection

What was measured: Proportion of adult hospital admissions assessed for risk of VTE on admission to hospital using the National VTE Risk Assessment Tool.
Data collection end: March 2019
96%
Number that met the criteria: 3687183 / 3851296
Area covered: England
Source: VTE Risk Assessment Data Collection


Recommendation: 1.1.5

Assess all surgical and trauma patients to identify the risk of VTE and bleeding: - As soon as possible after admission to hospital or by the time of the first consultant review - Using a tool published by a national UK body, professional network or peer-reviewed journal. The most commonly used risk assessment tool for surgical patients is the Department of Health VTE risk assessment tool[1]. [2018]

What was measured: Proportion of people aged 17 and over, who presented to an emergency department with a lower limb injury and were discharged with temporary immobilisation of the limb, who had their risk of VTE and bleeding assessed during their visit to the emergency department.
Data collection end: January 2019
45%
Area covered: UK
Source: Royal College of Emergency Medicine. VTE risk in lower limb immobilisation.

What was measured: Proportion of people aged 17 and over, who presented to an emergency department with a lower limb injury, were discharged with temporary immobilisation of the limb and had their risk of VTE and bleeding assessed during their visit to the emergency department, whose level of VTE risk was explicitly documented in their notes.
Data collection end: January 2019
74%
Area covered: UK
Source: Royal College of Emergency Medicine. VTE risk in lower limb immobilisation.

What was measured: Proportion of emergency departments which reported using an assessment tool published by a national UK body to assess the risk of VTE and bleeding in adult patients who are discharged with a new leg cast or boot.
Data collection end: January 2019
15%
Area covered: UK
Source: Royal College of Emergency Medicine. VTE risk in lower limb immobilisation.

What was measured: Proportion of emergency departments which reported using a locally developed assessment tool to assess the risk of VTE and bleeding in adult patients who are discharged with a new leg cast or boot.
Data collection end: January 2019
67%
Area covered: UK
Source: Royal College of Emergency Medicine. VTE risk in lower limb immobilisation.

What was measured: Proportion of emergency departments which reported using an assessment tool published by a professional network to assess the risk of VTE and bleeding in adult patients who are discharged with a new leg cast or boot.
Data collection end: January 2019
4%
Area covered: UK
Source: Royal College of Emergency Medicine. VTE risk in lower limb immobilisation.


Recommendation: 1.1.7

If using pharmacological VTE prophylaxis for surgical and trauma patients, start it as soon as possible and within 14 hours of admission, unless otherwise stated in the population-specific recommendations (see sections 1.10 to 1.15). [2018]

What was measured: Proportion of people aged 17 and over, who presented to an emergency department with a lower limb injury, were discharged with temporary immobilisation of the limb and for whom pharmacological thromboprophylaxis was indicated, who had this initiated in the emergency department.
Data collection end: January 2019
40%
Area covered: UK
Source: Royal College of Emergency Medicine. VTE risk in lower limb immobilisation.

What was measured: Proportion of people aged 17 and over, who presented to an emergency department with a lower limb injury, were discharged with temporary immobilisation of the limb and for whom pharmacological thromboprophylaxis was indicated, who had the first dose before discharge from the emergency department.
Data collection end: January 2019
18%
Area covered: UK
Source: Royal College of Emergency Medicine. VTE risk in lower limb immobilisation.


Recommendation: 1.2.4

As part of the discharge plan, give patients and their family members or carers (as appropriate) verbal and written information on: - the signs and symptoms of deep vein thrombosis (DVT) and pulmonary embolism - how people can reduce their risk of VTE (such as keeping well hydrated and, if possible, exercising and becoming more mobile) - the importance of seeking help if DVT, pulmonary embolism or other adverse events are suspected.

What was measured: Proportion of trusts who distribution of patient information leaflet produced by an external organisation on VTE prevention.
Data collection end: March 2018
21%
Area covered: National
Source: All Party Parliamentary Thrombosis Group Report

What was measured: Proportion of trusts who have a documented patient discussion with healthcare professional on VTE prevention.
Data collection end: March 2018
38%
Area covered: National
Source: All Party Parliamentary Thrombosis Group Report

What was measured: Proportion of people aged 17 and over, who presented to an emergency department with a lower limb injury and were discharged with temporary immobilisation of the limb, who were given an information leaflet on the risk of VTE, symptoms and where to seek medical help.
Data collection end: January 2019
23%
Area covered: UK
Source: Royal College of Midwives. Infant feeding: Supporting parent choice.



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