A CLINICAL AUDIT ON VENOUS THROMBOEMBOLISM PROPHYLAXIS IN TERTIARY CARE INTENSIVE CARE UNIT.

Background: In recent decades, venous thromboembolism (VTE) has been acknowledged as a health issue that can be prevented. Among hospitalized patients, thromboembolism is a serious complication. Patients in the intensive care unit (ICU) are more susceptible to thrombotic events because of supplementary risk factors like central catheters, mechanical ventilation, and immobilization. Aim: This study aims to assess the appropriateness of VTE prophylaxis practices in a medical ICU of a tertiary care hospital. The IMPROVE VTE RAM was compared with clinical judgment for any significant difference in the risk assessment. Methods: It was a retrospective cross sectional observational study carried out on the patients admitted to the medical ICU of the Vascular Surgery department from March 2023 to August 2023. Medical records and risk assessment were done using the IMPROVE VTE RAM. The prophylaxis was given to patients based on American Society of Haematology (ASH) guidelines. Results: This was a 6 months retrospective study and a total number of 50 patients were included in the study. However, appropriate risk assessment was not done in any patient. Based on IMPROVE VTE RAM 1 patient (2%) was in low risk, 37 (74%) in moderate risk, and 12 (24%) in high risk for VTE. Thus Prophylaxis was given to a total of 44 patients out of which 27 received unfractionated heparin and the rest of all patients received Low Molecular Weight Heparin. Mechanical prophylaxis was given to 2 patients. The regular emphasis on DVT prophylaxis and the critical care nurses' ongoing daily audit were able to commence DVT prophylaxis in the majority of patients. According to IMPROVE VTE RAM, the accuracy of clinicians' judgment in comparison to validated risk assessment tools was only 89%. Conclusion: Critically ill admitted patients are more likely to experience VTE and bleeding episodes. Therefore adequate prophylaxis is essential but unfortunately is not routinely used in critical care settings. There is an urgent need to identify the gaps and address areas such as thromboprophylaxis and consistent care that require attention. Healthcare professionals must be made aware of the significance of risk assessment for bleeding and VTE in all critically ill patients, using any validated risk assessment tool. [ABSTRACT FROM AUTHOR]