AB201. SOH21AS127. Venous thromboembolism prophylaxis in orthopaedic patients: has digital record keeping improved compliance?

Background: Venous thromboembolism (VTE), manifesting as pulmonary embolism (PE) and deep vein thrombosis (DVT), is a common preventable cause of morbidity and mortality among hospital patients however is often overlooked as a major public health problem. Common triggers include surgery, immobilization and hospitalization so orthopaedic patients undergoing joint replacements are particularly susceptible. VTE prophylaxis using prophylactic low molecular weight heparin alongside thromboembolic deterrent stockings (TEDS) are the current international gold standard for all orthopaedic inpatients. This study aims to audit compliance in prescribing VTE prophylaxis on our orthopaedic wards following the introduction of digital medical records in 2019.

Methods: A retrospective review of paper medication charts for all patients on the orthopaedic ward in a private teaching hospital over a one-week period in October 2018. Intervention in December 2019 includes the addition of a compulsory VTE risk assessment section into each patient’s electronic admission note as a reminder to prescribe appropriate VTE prophylaxis. Digital medication records re-audited over the same period in October 2020 and statistical analysis used to identify any discrepancies between these periods. All patients were reviewed for prescriptions of VTE prophylaxis, noting any inadequate dosing or inappropriate use of TEDS.

Results: This study in currently ongoing.

Conclusions: Data to date corroborates improved VTE prescribing compliance since the introduction of electronic medical records. We intend to complete data collection by December 2020.

Keywords: Venous thromboembolism (VTE); pulmonary embolism (PE); deep vein thrombosis (DVT); low molecular weight heparin, thromboembolic deterrent stockings (TEDS)