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05 December 2011

Thrombosis Risk Assessments at University Hospitals Bristol Exceed the National Standard

Following a recommendation by the Chief Medical Officer that at least 90% of hospital patients should be assessed for the likelihood of developing Venous Thromboembolism (VTE:  blood clots in a vein, such as pulmonary embolism or deep vein thrombosis), University Hospitals Bristol NHS Foundation Trust (UH Bristol) is consistently reporting figures well above the national standard, achieving its own local standard of 95% or more each month. 

It is estimated that nationally VTE is responsible for around 25,000 hospital deaths each year. Completing risk assessments allows action to be taken to prevent a clot forming, such as prescribing medication or anti-embolism stockings.  

"Hospital acquired thrombosis is a well recognised complication of being admitted to hospital," says Dr Sean O'Kelly, Medical Director at UH Bristol.  "Good performance in this area is something that makes a great difference overall to care and UH Bristol has promoted VTE risk assessment to priority level since it was first on the national agenda." 

Two VTE project nurses have been introduced as a job-share at the Trust, working with VTE clinical lead Dr Amanda Clark, a consultant haematologist.   Together they have orchestrated and helped to embed positive changes that ensure all adult patients are VTE risk assessed at the time of admission.  This is then reinforced throughout a patient's hospital stay:  it forms part of a patient's prescription chart; is being incorporated into 'status at a glance' boards on the wards; and is integral to the patient discharge screen as a mandatory field to confirm whether a VTE risk assessment was completed, thus ensuring an accurate method of recording. 

VTE risk assessment awareness days are held regularly at UH Bristol, aimed at staff, medical students and patients, and the team are working continually to improve the education of nursing staff and doctors.   Earlier this year, VTE project nurse Lucy Wike was presented with a certificate at the House of Commons making her an ambassador for the thrombosis charity, Lifeblood, in recognition of the contribution she has made to reducing hospital acquired thrombosis. 

"In many cases hospital acquired thrombosis can be prevented by taking simple measures," says Dr Amanda Clark.  "Once patients have been VTE risk assessed, and in some cases prescribed treatment, patients can also help themselves by keeping well hydrated, both in hospital and during convalescence; carry out simple passive leg exercises in bed; and, while in hospital, question their doctor about their VTE risk assessment and what treatment was considered right for them."