Following established anti-blood clotting guidance could save hundreds of lives according to a National Assembly committee
10 October 2012
Hundreds of lives could be saved in Wales if clinicians adhered to established guidelines to prevent venous thromboembolism (VTE), according to a National Assembly for Wales Committee.
During its inquiry, the Health and Social Care Committee was told that, in 2010, approximately 900 deaths in Wales were due to - or associated with - hospital-acquired blood clots or thromboses. This figure is substantially higher than the combined number of people who died from MRSA, breast cancer or AIDS in Wales during the same year.
The Committee was also told that 70 per cent of such deaths could have been avoided had appropriate preventative measures been put in place.
The Committee found that the National Institute for Clinical Excellence (NICE) had published guidelines in 2010, based on advice from a number of multidisciplinary medical experts, which recommended a risk assessment be carried out on each patient. But the Committee also found that these guidelines were often ignored.
“Risk assessment alone will not ensure patients avoid developing blood clots during hospital care. It has to be considered alongside the use of appropriate treatment – whether in the form of blood thinning medicines or specialist stockings – if lives are going to be saved,” said Mark Drakeford AM, Chair of the Health and Social Committee.
“But the Committee has grave concerns about clinicians routinely ignoring guidelines set down by their peers.
“We are also concerned that assessment methods are not just inconsistent across local health boards in Wales but inconsistent across different departments within the same hospital.
“Therefore we recommend that the Welsh Government establish a standard procedure to record and reduce cases of hospital-acquired thrombosis which would be mandatory across all local health boards.
“We also believe the performance of local health boards in reducing the number of blood clot cases should be measured as a priority.”
The Health and Social Care Committee makes five recommendations in its report:
That the Welsh Government recognises the importance of reducing the incidence of Hospital-Acquired Thrombosis in Wales by actively considering whether compliance with the relevant NICE guidance should be included as a tier 1 priority for health boards, against which they will be performance-managed. The Welsh Government should report back to us the outcome of the consideration it gives to including compliance with the NICE guidance as a tier 1 priority and explains the reasons for the conclusion it reaches;
That a standard procedure be implemented to reduce Hospital-Acquired Thrombosis in Wales, mandating clinicians to risk assess and to consider prescribing appropriate thromboprophylaxis – mechanical or chemical – for all hospitalised patients;
Tat health boards should develop a standardised method to demonstrate a Hospital-Acquired Thrombosis rate for each hospital in Wales and at a national, all-Wales level;
That a root-cause analysis should be undertaken for each case of VTE at Welsh hospitals, or for patients presenting VTE within three months of being discharged from a Welsh hospital, to establish whether they were acquired as a result of hospital treatment;
The Welsh Government and health boards should work together to raise awareness amongst patients and clinicians of the risks of developing hospital acquired thrombosis (HAT). This should take the form of a public education campaign to improve understanding of the risks of HAT and the severity of the problem.
And, the Welsh Government and health boards should work together to raise awareness amongst patients and clinicians of the risks of developing hospital acquired thrombosis (HAT). This should take the form of a public education campaign to improve understanding of the risks of HAT and the severity of the problem.