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Background: Hospital-acquired venous thromboembolisms (VTEs) account for 50-60% of all VTEs observed. Surgical patients are particularly at risk, and preventative measures such as thromboembolism deterrent stockings (TEDs) and low molecular weight heparin (LMWH) proves to be beneficial. The National Quality Requirement in the NHS Standard Contract 2017/19 mandates that 95% of patients undergo VTE risk assessments. Due to nationwide transitions into electronic patient records (EPR), it is important to observe the impact on the completion of vital assessments such as VTE risk. The aim of this study is to observe the effect of implementing EPR in a tertiary hospital on VTE assessments and prophylaxis administration in admitted surgical patients.Methods: Using consecutive sampling method, all acute surgical admissions at the St. George’s Surgical Admissions Unit from 26th February to 18th March (n=154) pre-EPR and 31st October to 25th November (n=151) post-EPR implementation were observed for VTE risk assessment, 24-hour re-assessment, prophylaxis (LMWH, TED stockings) prescription, administration, and patient compliance. These two sets of data were compared using a two-tailed Z test to evaluate the effect of EPR on assessment completion, and to observe if national targets were met.Results: Pre-EPR, 96% of patients had a completed VTE assessment, which increased after EPR implementation to 97% (p=0.39). LWMH prescription rates decreased from 82% to 77%, following EPR (p=0.14). Moreover, TEDs prescriptions decreased from 84% to 64% post-EPR (pConclusions: This study demonstrated that current practice met national requirements of VTE assessment. EPR implementation is associated with improved rates in administration of thromboprophylaxis. However, there is still much room for improvement in adherence to risk assessment completion. Data collection post-EPR began immediately after EPR implementation. Thus, lack of confidence and familiarity of the new system could have influenced assessment rates. A multifactorial approach is required when making large transitions, including enhancing staff attitude, increasing EPR training and assessments in individual Trust’s technological needs to achieve a standard use capability. |
