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Thromboprophylaxis use in medical and surgical inpatients and the impact of an electronic risk assessment tool as part of a multi-factorial intervention. A report on behalf of the elVis study investigators

Janus, Edward, Bassi, Anmol, Jackson, David, Nandurkar, Harshal and Yates, Mark 2011, Thromboprophylaxis use in medical and surgical inpatients and the impact of an electronic risk assessment tool as part of a multi-factorial intervention. A report on behalf of the elVis study investigators, Journal of Thrombosis and Thrombolysis, vol. 32, pp. 279-287, doi: 10.1007/s11239-011-0602-9.

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Title Thromboprophylaxis use in medical and surgical inpatients and the impact of an electronic risk assessment tool as part of a multi-factorial intervention. A report on behalf of the elVis study investigators
Author(s) Janus, Edward
Bassi, Anmol
Jackson, David
Nandurkar, Harshal
Yates, Mark
Journal name Journal of Thrombosis and Thrombolysis
Volume number 32
Start page 279
End page 287
Total pages 9
Publisher Springer New York LLC
Place of publication New York, N.Y.
Publication date 2011-10
ISSN 0929-5305
1573-742X
Keyword(s) Adult
Aged
Aged, 80 and over
Female
Guideline Adherence
Humans
Male
Medical Records Systems, Computerized
Middle Aged
Practice Guidelines as Topic
Prospective Studies
Risk Assessment
Risk Factors
Software
Venous Thromboembolism
Summary Venous thromboembolism (VTE) is a major source of morbidity and mortality for both surgical and medical hospitalised patients. Despite the availability of guidelines, thromboprophylaxis continues to be underutilised. This study aims to assess the effectiveness of an electronic VTE risk assessment tool (elVis) on VTE prophylaxis in hospitalised patients. A national, multicentre, prospective clinical audit collected information on VTE prophylaxis and risk factors for VTE in 2,400 hospitalised patients (comprising of equal numbers of medical, surgical and orthopaedic patients). After auditing the standard care use of VTE prophylaxis in 1,200 consecutive patients (audit 1, A1), the elVis system was installed and a second audit (A2) of VTE prophylaxis was performed in a further 1,200 patients. The use of the electronic VTE risk assessment tool was low with 20.5% of patients assessed with elVis. The intervention, elVis plus accompanying education, improved the use VTE prophylaxis to guidelines by 5.0% amongst all patients and by 10.7% amongst high risk patients (adjusted odds ratio (AOR) 1.27 and 1.65 respectively). The use of elVis in A2 varied between hospitals and specialties and this resulted in marked heterogeneity. Despite this heterogeneity, patients assessed with elVis had 1.44 times higher AOR of being treated to guidelines compared to those who were not (P < 0.05). The use of elVis accompanied by staff education improved VTE prophylaxis, especially amongst high risk patients. To optimise the effectiveness and support enduring practice change electronic systems, such as elVis, need to be completely integrated within the treatment pathway.
Language eng
DOI 10.1007/s11239-011-0602-9
Field of Research 110399 Clinical Sciences not elsewhere classified
1103 Clinical Sciences
HERDC Research category C1.1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2011, The Authors
Free to Read? Yes
Use Rights Creative Commons Attribution non-commercial licence
Persistent URL http://hdl.handle.net/10536/DRO/DU:30101117

Document type: Journal Article
Collections: Faculty of Health
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Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.