Title : Improving pharmacological DVT prophylaxis compliance using an electronic alert system in an acute surgical ward; A quality improvement project
Abstract:
Aim: To achieve ≥90% compliance with timely pharmacological DVT prophylaxis (within 14 hours of admission) in surgical inpatients by introducing an automated electronic alert system.
Methods: This quality improvement project analysed all new adult admissions into Ward 4 (General Surgery) in a period of 4 months. Baseline compliance from the data before the implementation of the alert system was 84.8%. The intervention consisted of a daily HEPMA electronic alert, emailed at at 8am every morning, listing patients not yet prescribed Enoxaparin, prompting review on morning ward rounds. Data were captured for: VTE risk assessment completion, eligibility, prescribing accuracy, dose appropriateness, timeliness of administration, and final compliance.
Results: Across 55 patients in Cycle 2:
- 100% completed VTE risk assessments
- 100% of eligible patients were prescribed pharmacological prophylaxis
- 100% of alerts successfully triggered
- 94.5% (52/55) received prophylaxis within 14 hours of admission
- 96.4% (53/55) met full final compliance criteria
- Dose adjustments for renal impairment or high weight were correct in 98% of cases
Only three patients fell outside the 14-hour window: one due to delayed correction of an initial underdose, one awaiting confirmation of eligibility, and one administered after email prompting.
Conclusion: The introduction of an automated electronic alert system substantially improved the timeliness and completeness of pharmacological DVT prophylaxis, raising overall compliance from 84.8% to 96.4%. The system ensures reliable daily identification of at-risk risk patients and offers a scalable, low-burden intervention suitable for wider adoption across NHS Lanarkshire surgical wards.
