Pharmacological prophylaxis for venous thromboembolism in hospitalized surgical patients at a secondary teaching hospital: a best practice implementation project.

INTRODUCTION: Thromboprophylaxis reduces venous thromboembolism (VTE) in hospitalized patients. However, despite robust evidence, financial constraints, structural barriers-including limited access, socioeconomic inequalities-alongside patient complexity and diagnostic challenges, contribute to persistently high thromboembolism-related mortality. AIM: This project aimed to improve VTE prophylaxis in surgical patients through the implementation of evidence-based practices in a secondary teaching hospital in Brazil. METHODS: This evidence implementation project was guided by the JBI Evidence Implementation Framework and used the JBI Practical Application of Clinical Evidence System (PACES) and the JBI Getting Research into Practice (GRiP) tools. Eight audit criteria were developed to assess baseline compliance with best practices. A barrier analysis was conducted, strategies were implemented to address gaps, and follow-up audits were conducted to evaluate changes. RESULTS: Non-compliance was identified in six of the eight criteria. Key barriers included the absence of a standardized pharmacological prophylaxis protocol and insufficient adherence to patient risk assessment upon admission. Strategies included the development of an evidence-based protocol and staff training. Partial improvement was observed following implementation. Criterion 4 achieved full compliance, while Criteria 3 and 6 maintained optimal performance. Criterion 1 showed statistically significant improvement (p < 0.05). However, no significant changes were observed in Criteria 5 and 7, and persistent gaps remained in risk reassessment and discharge guidance. CONCLUSION: Targeted interventions improved adherence to several best practices; however, important gaps remain. Continuous monitoring, staff education, and structured implementation strategies are essential to enhance patient safety. SPANISH ABSTRACT: https://links.lww.com/IJEBH/A705.