NICE launches guideline on reducing risk of VTE
Zephyr/Science Photo Library
Pulmonary embolism can occur as a result of deep vein thrombosis |
Best practice advice on reducing the risk of venous thromboembolism (VTE) for inpatients undergoing surgery is published by the National Institute for Health and Clinical Excellence in a clinical
guideline this week.
All surgical patients requiring an overnight stay should be assessed
for individual risk factors for VTE (deep vein thrombosis and pulmonary
embolism), it says. Patients should be offered thigh-length graduated
compression stockings, unless contraindicated. Knee-length stockings
can be used if thigh-length stockings are deemed inappropriate for reasons
of fit or compliance, it says.
In addition to mechanical prophylaxis, patients who have risk factors
for VTE, and patients having orthopaedic surgery, should be offered low
molecular weight heparin, says the guideline. Fondaparinux, within its
licensed indications, may be used as an alternative, it adds. This prophylaxis
should be continued for four weeks after hip fracture surgery.
The guideline also specifies that health care professionals should advise
patients to consider stopping combined oral contraceptive use four weeks
before elective surgery and that verbal and written information about
the risks of VTE and the effectiveness of prophylaxis should given to
patients before surgery.
Robin Offord, director of clinical pharmacy at University College London
Hospitals NHS Foundation Trust and a member of the guidance development
group, believes that the guideline represents a real opportunity for
pharmacists to influence best practice within their organisations.
“Most health care professionals focus their attentions on defined
clinical areas, yet this guidance will impact on many different surgical
specialties.
Due to the diversity of their core service, pharmacy staff are ideally
placed to ensure consistently high standards are achieved for patients
across health care organisations, and I would expect them to be actively
involved in multidisciplinary teams implementing the guidance, and evaluating
its ongoing success,” he said.
The full guideline is available on the NICE
website
Independent
report Every
hospital patient in England should have a risk assessment for venous
thromboembolism, an independent expert working group has recommended.
The
group’s report, launched last week by Chief Medical
Officer, Liam Donaldson, says that core standards should be set
by the Department of Health and compliance
with these standards should be monitored by the Healthcare Commission. The report
also recognises pharmacists’ role in thromboprophylaxis and recommends
that a lead pharmacist for thromboprophylaxis should be identified in each trust.
The
CMO has established an implementation working group to develop a national risk
assessment tool. |
|
The
Pharmaceutical Journal
Acrobat
Reader