STAMP: surgical thromboprophylaxis adherence management programme.

Abstract

Introduction: Venous thromboembolism is the main cause of preventable in-hospital morbidity and mortality. Despite the recommendations available in the clinical practice guideline, there is low adherence to correct thromboprophylaxis. The implementation of strategies in other countries has had a significant effect on this shortcoming. The objective of the current study was to develop and apply a multifaceted strategy to improve adherence to the institutional protocol of thromboprophylaxis in surgical patients in a university hospital.

Methods: This was a quasi-experimental before-and-after study. Adequate adherence to the institutional thromboprophylaxis guide for surgical patients was evaluated by performing an initial measurement, then a multifaceted intervention and, finally, a second measurement. The information was collected from electronic medical records. The study population was a multidisciplinary healthcare team. χ² tests and Student's t tests were used for the analysis of categorical and numerical variables.

Results: In total, 192 medical records were included for the two measurements. The strategy comprised the following: inclusion of the Caprini scale in the electronic system, creation and dissemination of the institutional thromboprophylaxis booklet, conducting information sessions, creating an online course and creating an alert for high-risk and very high-risk thromboembolic patients. The implementation of the strategy significantly increased adequate adherence to the institutional thromboprophylaxis guide according to the thromboembolic risk of the patient calculated by the Caprini scale (40.2% vs 62.7%, p 0.003).

Conclusion: The use of a multifaceted strategy to improve adherence to thromboprophylaxis in surgical patients should be considered locally and internationally.