Effectiveness of Resident Education on Thromboembolism Prophylaxis: Insights From a Quality Improvement Project Improving the Appropriate Use of Thromboembolism Prophylaxis Among Resident Inpatient Teams: A Quality Improvement Project.

Abstract

Background and objectives: Venous thromboembolism (VTE) prophylaxis remains important in managing hospitalized patients. Many studies have been done to incorporate educational interventions and other measures to help achieve better rates of appropriate VTE prophylaxis usage. Our objective was to study the sole impact of resident education, focusing on reducing heparin usage compared to low molecular weight heparin.

Methods: This study was carried out in a single upstate New York hospital. Preintervention data were collected regarding VTE prophylaxis usage among the resident team for 5 weeks followed by a month of educational intervention where residents were given PowerPoint presentations and handouts during our educational conferences. Postintervention data were then collected for a 5-week period and subsequently analyzed.

Results: The preintervention arm had 579 patients, while the postintervention arm had 311 patients. Our results did not show a statistically significant decrease in inappropriate heparin use after the intervention (20.8% vs 17.5%, P value = .326). A higher nonstatistically significant percentage of patients were shifted from Heparin to Enoxaparin on resolution of acute kidney injury in the postintervention group (73.9% vs 55.2%, P value = .077). There was no difference in adverse events of heparin induced thrombocytopenia, bleeding, and deep venous thrombosis/pulmonary embolism between the groups.

Conclusions: Our study suggests that education alone cannot significantly change appropriate VTE usage rates. Other means of increasing appropriate VTE usage or a combination of education with other means need to be explored further.