Venous Thromboembolism Risk Assessment and Prophylaxis Administration among Admitted Patients in Lagos, Nigeria: A Quality Improvement Project

TL;DR

This study aimed to improve VTE risk assessment and prophylaxis in a Nigerian hospital through education and a risk model.

Contribution

The study introduced the Caprini RAM and education to improve VTE risk assessment practices in a Nigerian hospital.

Findings

No patients were assessed for VTE risk in the first cycle.

56% of patients were assessed for VTE risk in the second cycle after education and the Caprini RAM introduction.

Abstract

Venous thromboembolism (VTE) is a potentially life-threatening and costly complication of hospitalization. In many developing countries, VTE risk assessment at admission is not routinely conducted. This quality improvement project aimed to audit and improve the VTE risk assessment and prophylaxis administration among patients admitted to the Meridian Cardiac Centre in Lagos, Nigeria, over two cycles.

This was a quality improvement project. The National Institute for Health and Clinical Excellence (NICE) guideline NG89 served as the standard. In the second cycle, the Caprini Risk Assessment Model (RAM) was introduced for assessing VTE risk at admission. The RAM was also retrospectively applied to assess patients' VTE risk categories in both cycles.

No patients were assessed for their VTE risk during the first cycle. By the second cycle, following an educational meeting and the introduction of the Caprini RAM, 56% of patients were assessed for their VTE risk.

VTE risk assessment practices were poor in this facility. Continuous education for medical practitioners and proper documentation of clinical notes will improve the categorization of medical inpatients based on their VTE risk and improve the outcomes of future audits.