Adamali H, Suliman A M, Zaid H, O'Donoghue E, Burke A, Suliman A W, Salem M, O'Toole A, Yearoo A Ibrahim, Javid S, Ullah I, Bolger K, Dunican E, McCullagh B, Curtin D, Lonergan M T, Dillon L, Murphy A W, Gaine S
Mater Misericordiae University Hospital, Eccles St, Dublin 7.
Kerry General Hospital, Tralee, Co Kerry.
Ir Med J. 2013 Nov-Dec;106(10):302-5.
We established a national audit to assess the thromboprophylaxis rate for venous thromoembolism (VTE) in at risk medical patients in acute hospitals in the Republic of Ireland and to determine whether the use of stickers to alert physicians regarding thromboprophylaxis would double the rate prophylaxis in a follow-up audit. 651 acute medical admission patients in the first audit and 524 in the second re-audit were recruited. The mean age was 66.5 yrs with similar numbers of male and female patients and 265 (22.6%) patients were active smokers. The first and second audits identified 549 (84%) and 487 (93%) of patients at-risk for VTE respectively. Of the at-risk patients, 163 (29.7%) and 132 (27.1%) received LMWH in the first and second audit respectively. Mechanical thromboprophylaxis was instigated in 75 (13.6%) patients in the first and 86 (17.7%) patients in the second audit. The placement of stickers in patient charts didn't produce a significant increase in the number of at risk patients treated in the second audit. There is unacceptably low adherence to the ACCP guidelines in Ireland and more complex intervention than chart reminders are required to improve compliance.
我们开展了一项全国性审计，以评估爱尔兰共和国急性医院中高危内科患者的静脉血栓栓塞（VTE）预防率，并确定使用贴纸提醒医生进行血栓预防是否会使后续审计中的预防率翻倍。首次审计招募了651名急性内科入院患者，二次重新审计招募了524名患者。平均年龄为66.5岁，男女患者数量相近，265名（22.6%）患者为现吸烟者。首次和二次审计分别确定了549名（84%）和487名（93%）VTE高危患者。在高危患者中，首次和二次审计分别有163名（29.7%）和132名（27.1%）接受了低分子肝素治疗。首次审计中有75名（13.6%）患者、二次审计中有86名（17.7%）患者采取了机械性血栓预防措施。在二次审计中，在患者病历中放置贴纸并没有使接受治疗的高危患者数量显著增加。爱尔兰对美国胸科医师学会（ACCP）指南的依从性低得令人无法接受，需要比病历提醒更复杂的干预措施来提高依从性。
