Improving thromboprophylaxis in the medical inpatients: The role of the resident in an academic hospital

Phlebology. 2023 Mar;38(2):91-95. doi: 10.1177/02683555221147472. Epub 2022 Dec 20.

Abstract

Introduction: Venous thromboembolism (VTE) is one of the main causes of preventable in-hospital death. It is recommended for hospitals to have an appropriate thromboprophylaxis (TP) protocol to avoid VTE complications.

Objective: To determine the effect of the resident physician feedback to the staff physician in TP appropriateness after the Caprini RAM score implementation.

Methods: Caprini RAM was implemented by the residents in medical patients. Patients were divided in low, moderate, high, and highest-risk groups, with TP recommendation accordingly. In cases with inadequate TP, the resident provided feedback to the staff physician for adjustment. Change to appropriate TP was assessed retrospectively.

Results: A total of 265 records were included. Before intervention, 193 (72.8%) patients had appropriate TP and post-intervention, 207 (78.1%) patients received adequate TP (p < .001).

Conclusions: Feedback from the internal medicine resident to staff physician improves appropriate TP in medical inpatients as a quality of care strategy.

Keywords: Deep vein thrombosis; venous thromboembolism; venous thromboembolism prophylaxis.

MeSH terms

  • Anticoagulants / therapeutic use
  • Hospital Mortality
  • Hospitals
  • Humans
  • Inpatients
  • Retrospective Studies
  • Risk Assessment / methods
  • Risk Factors
  • Venous Thromboembolism* / prevention & control

Substances

  • Anticoagulants