Venous thromboembolism prophylaxis: the role of the nurse in changing practice and saving lives

Background: Venous thromboembolism (VTE) predominantly afflicts surgical and medical patients in an acute hospital setting. Responsibility for VTE risk assessment and appropriate prophylaxis to prevent this major health burden rests with a variety of clinical staff. All too frequently, however, patients do not undergo VTE risk assessment on admission. This is regardless of the fact that a number are at risk for VTE, receive no prophylaxis and unknowingly are at risk of serious adverse events including death. Objective: The broad aims of this paper is to provide evidence based information on VTE and to report on the rate of appropriate VTE prophylaxis pre and post nursing educational sessions. Setting: This paper describes a nurse led initiative undertaken at a tertiary level acute care facility in Queensland. Subjects: A clinical audit was conducted on 2,063 hospitalised inpatients. Primary argument: Nurses who are empowered through evidence based education sessions can take responsibility for VTE risk assessment of all admitted patients and ensure appropriate VTE prophylaxis is provided. The rates for appropriate prophylaxis in admitted patients at risk of VTE increased from 27% to 85% (p< 0.0001). Through appropriate prophylaxis of patients at risk of VTE, the incidence of VTE will be significantly reduced. Conclusions: Nurses who are committed to VTE risk assessment and prophylaxis have the ability to contribute significantly to the reduction of VTE and its subsequent complications