Thromboprophylaxis

Prophylactic measures to prevent venous thromboembolism (VTE) are based on individual VTE risk assessment as described in the previous section. The methods of prophylaxis are termed mechanical, for example wearing anti-embolism stockings, or pharmacological, for example heparin. The National Institute of Health and Care Excellence (NICE) recommendations include recommendations for the type of prophylaxis [27].

Mechanical methods of prophylaxis

The objective of the mechanical measures is to increase the flow rate of venous blood to prevent thrombi formation. Mechanical methods reduce the incidence of deep vein thrombosis (DVT), but the evidence base for their use is more limited than that for pharmacological thromboprophylaxis. [8]


Ensuring quality in VTE prevention

The quality standard for VTE from NICE highlights that an integrated approach to provision of services is fundamental to the delivery of high-quality care to patients for prevention and management of VTE and identifies seven quality standards for VTE prevention.

NICE Quality Standard for VTE Prevention (QS3) [28]
1 All patients, on admission, receive an assessment of VTE and bleeding risk using the clinical risk assessment criteria described in the national tool
2 Patients/carers are offered verbal and written information on VTE prevention as part of the admission process
3 Patients provided with anti-embolism stockings have them fitted and monitored in accordance with NICE guidance
4 Patients are re-assessed within 24 hours of admission for risk of VTE and bleeding
5 Patients assessed to be at risk of VTE are offered VTE prophylaxis in accordance with NICE guidance
6 Patients/carers are offered verbal and written information on VTE prevention as part of the discharge process
7 Patients are offered extended (post hospital) VTE prophylaxis in accordance with NICE guidance