Assessment of Venous Thromboembolism (VTE) Risk Evaluation and Compliance With Guidelines in Surgical Patients: A Clinical Audit at the Prince Osman Digna Referral Hospital

Abstract

Background Venous thromboembolism (VTE), encompassing deep vein thrombosis (DVT) and pulmonary embolism (PE), is a leading cause of avoidable hospital-acquired morbidity and mortality. Despite clear international guidelines from bodies such as the American College of Chest Physicians (ACCP) and the National Institute for Health and Care Excellence (NICE), compliance in surgical settings remains suboptimal. This clinical audit aimed to evaluate and improve the documentation and implementation of VTE risk assessment and prophylaxis among surgical patients. Methods A closed-loop clinical audit was conducted at Prince Osman Digna Referral Hospital, Port Sudan, Sudan. The study included retrospective and prospective data collection across two audit cycles, the first involving 50, and the second cycle, 47 randomly selected surgical inpatient records. Data were gathered using a standardized tool aligned with international guidelines. Interventions between the cycles included educational workshops, implementation of standardized assessment forms, visual aids, and feedback sessions. Data were analyzed using descriptive statistics and the Chi-square test to determine changes in compliance. Results In the first cycle (N = 50), compliance was poor: zero (0%) had Caprini scores documented, and 49 (98%) received no prophylaxis. Following targeted interventions, the second cycle (N = 47) showed significant improvement. Caprini score documentation increased to 39 (83%), early mobilization to 30 (63.8%), and LMWH administration to nine (19.1%). Use of TED stockings rose to eight (17%), while those receiving no prophylaxis dropped to seven (14.9%). Documentation of prophylaxis duration improved to 37 (78.7%), compared to one (2%) in the first cycle. Guideline-consistent management plans increased from one (2%) to 30 (65.2%), and education on VTE risk and prophylaxis rose from one (2%) to 20 (42.6%). All improvements were statistically significant (p < 0.05). Conclusion Targeted interventions led to substantial improvements in VTE risk assessment and prophylaxis practices. Standardized tools, clinician education, and systematic feedback proved effective in promoting adherence to evidence-based guidelines. Sustained efforts are essential to maintain compliance and enhance patient safety.