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116 Improving VTE Risk Assessment for Hospice Inpatients
  1. Serena Chew,
  2. Francesca Aquilina,
  3. Debbie Adams and
  4. Helen Lock
  1. Hospiscare


Background & Aims Hospice inpatients are often at higher risk of developing venous thromboembolic (VTE) events, but also often have various contra-indications to VTE prophylaxis. Careful assessment based on a risk-benefit balance is important to ensure that decisions are made that support patients’ quality of life and symptom control. A project was carried out to review the local hospice’s practices on VTE risk assessment and management with primary prophylaxis, and documentation of this.

Methods An audit was conducted in February 2021, prompted by participation in the data collection for the national UK Palliative trainees Research Collaborative (UKPRC) VTE audit. A local VTE assessment tool was then developed based on NICE guidance and practices from hospices in other regions of England.1–2 The tool was then embedded into the electronic SystmOne software used by the inpatient hospice team. A re-audit of local practice was then performed in May 2022 to assess the impact of this intervention.

Findings and Discussion The electronic VTE assessment tool led to greater percentage of patients having a documented VTE risk assessment (87.5% vs 62.5%), and better documentation of outcome (100% vs 80%) and rationale for this (85.7% vs 40%). Decisions on prophylaxis were deemed to be appropriate. The study was limited by its small sample size (n=8 for each single day snapshot audit of cases). Further work will need to be done on: the appropriateness and timing of re-assessment of VTE risk; and discussion about decision-making around VTE prophylaxis with patients and their relatives.

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