A CLINICAL AUDIT ON THE VENOUS THROMBOEMBOLISM PROPHYLAXIS IN THE MEDICAL-SURGICAL INTENSIVE CARE UNIT OF A TERTIARY REFERRAL HOSPITAL

Delay in the initiation of venous thromboembolism (VTE) prophylaxis within the first 24 hours of intensive care unit (ICU) admission was associated with an increased risk of mortality. This study evaluated adherence towards VTE prophylaxis guidelines. A complete clinical audit cycle was performed in the medical-surgical ICU of a public tertiary state hospital. The standards were set as (1) all patients admitted to the ICU should receive pharmacological VTE prophylaxis within 24 hours of admission unless contraindicated and (2) all pharmacological VTE prophylaxis should be prescribed with the appropriate regimen. All adult ICU patients admitted in January 2023 were recruited in the phase one study, whereas all adult ICU patients admitted in January 2024 were recruited in the phase two study following an educational talk in August 2023. A total of 74 patients were recruited in the phase one study. Of these, only five (27.8%) indicated patients received pharmacological VTE prophylaxis within 24 hours of ICU admission. Two (40.0%) of them were underdosed with enoxaparin. Following educational intervention, 86 patients were recruited in the phase two study. Twelve (80.0%) indicated patients received pharmacological VTE prophylaxis within 24 hours of ICU admission. All of them received an appropriate dose of enoxaparin. The educational intervention improved the proportion of indicated patients receiving pharmacological VTE prophylaxis (p = 0.0083), and the proportion of patients receiving an appropriate enoxaparin regimen (p = 0.0735). A simple educational session was able to improve guideline adherence. A periodic educational session is warranted to ensure consistent adherence.