Preventing the Preventable: Enhancing VTE Risk Assessments in Geriatrics Wards

Background

Venous thromboembolism (VTE) is a leading cause of preventable hospital morbidity and mortality. Older adults admitted are at particularly high risk due to immobility, frailty, and comorbidities. NICE guideline NG89 recommends all hospital inpatients undergo a documented VTE risk assessment on admission and reassessment within 24 hours. An initial audit identified incomplete VTE assessments on prescription charts across two geriatric wards in our hospital.

Aim

To improve the completion rate of VTE risk assessments on two wards from baseline (80–86%) to 100%.

Methods

Prescription charts were reviewed over a 3-week pre-intervention period to establish baseline completion rates. Interventions included: (1) a targeted educational presentation delivered during weekly departmental teaching for resident doctors, and (2) posters displayed on stroke wards outlining the correct process for completing VTE assessments and prescribing prophylaxis for new and existing patients. Data collection was repeated over a 3-week post-intervention period.

Results

Pre-intervention VTE assessment completion rates were 86% (93/108) on Ward X and 80% (52/65) on Ward Y. Following the interventions, completion rates improved to 92.5% (99/107) and 98.4% (65/66), representing absolute increases of 6.5% and 18.4% respectively.

Conclusion

A simple, low-cost intervention combining junior doctor education and visual prompts improved VTE risk assessment completion on both wards. Sustaining improvements will require ongoing reinforcement and regular poster updates. Broader adoption of this approach could reduce preventable hospital-acquired VTE in vulnerable older inpatients.