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Implementing VTE Prophylaxis within NHS Ayrshire and Arran Lynsey Renfrew VTE Programme Manager Aim To reduce death and harm to patients within NHS Ayrshire and Arran from hospital acquired VTE…..how much by when? • Implement, promote and drive forward a VTE prevention across NHS Ayrshire and Arran acute services – Risk assessment tool – NHS Ayrshire and Arran care Bundle – Work with individual specialties – Data collection/evaluation tools – Promote current best practice – Training and education/patient awareness • Provide a coordinated approach to ensure promotion of best practice • Work in partnership with multidisciplinary teams to improve patient care and safety PDSA Process Aim: Test Risk Assessment Tool (DRAFT 1) in Pre-op Assessment Unit and Ward 2B Crosshouse Hospital Redesign policy to Care Bundle format Implement a VTE Risk Assessment tool and evidence Re-design to Flowchart based prescribing of appropriate Soften Language VTE prophylaxis within Orthopaedics NHS Ayrshire and Eliminate review process External Arran. Processes looked and compared Act Plan resources available. Ensure Use “opt-out” Risk Assessment Tested with elective patients by Verbal feedback negative programme manager, nurses, medical Lack of understanding of staff, pharmacists - 1/3/5 guidance to completing RAT Study Do Education about purpose and process No Patient involvement Department/Stakeholder buy in No Patient review Visual observation of processes, Prescribing Issues process broken done each element individually tested Poor RAT Compliance Pharmacy involvement PDSA Process Aim: Test Risk Assessment Tool (DRAFT 2) Ward 2B Crosshouse Hospital Drug choice agreed AES eliminated Implement a VTE Risk Assessment tool (DRAFT 2)and evidence based Sign and date added to be in nursing prescribing of appropriate VTE profile next kardex prophylaxis within Orthopaedics Recognise evidence base practice NHS Ayrshire and Arran Ensure resources available When and who to prescribed agreed Act Plan Positive feedback Tested with elective patients by medical staff - 1/3/5 VTEP prescribed correctly Re-Educate about purpose and Compliance Increased Study Doprocess of opt-out risk assessment Department/Stakeholder buy in Quicker, slicker process Visual observation of processes, Flowchart easy to follow process broken done each element individually tested Used as Reference document Pharmacy involvement Consultants reviewed document Learning Points Highs and Lows • VTE shared learning • No Buy In = No Success • Learning about Improvement • Resistors Methodology • Test Process/Refinement • PDSA method not recognised Process • No departmental engagement • Publicising and education • Knowledge deficit about Risk assessment • Networking • Developing Care Bundle, using this process to gain compliance • Positive result from compliance audit • Implementing evidence based practice • Sharing knowledge/practice VenousThromboEmbolism (VTE) Prophylaxis Bundle The Bundle All hospital in-patients are risk assessed for VTE prophylaxis. Prophylaxis is decided and Pharmacological and/or Mechanical methods are prescribed correctly. Ensure consistent review of risk assessment, changes documented and applied as per individual patient. After individual review consider extended prophylaxis on discharge from hospital. cont….
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