Authors (including presenting author) :
Wong SK(1), Woo CWY(1), Ng PL(1), Wong SW(1), Chan CK(2), Hui KF(2), Wong MK(2) ,Ng YB(2), Tam YM(3), Yu CT(3)
Affiliation :
(1) Physiotherapy Department, United Christian Hospital,
(2) Department of Medicine and Geriatrics, United Christian Hospital, (3) Nursing Services Department, United Christian Hospital
Introduction :
Clinical evidence revealed a strong relationship between ischemic stroke and venous thromboembolism (VTE), which may lead to high fatal consequence. Studies also suggested a multidisciplinary collaborative program was beneficial for VTE prevention. To deliver better care to the stroke patients in Acute Stroke Unit (ASU), United Christian Hospital (UCH) launched this service through the collaborative work from a group of committed health professionals in 2016 and got promising result.
Objectives :
To reduce the risk of VTE in for ASU patients during hospitalization, through a multi-disciplinary collaborative program.
Methodology :
A steering committee was set up in June 2016 to develop the VTE prevention program in ASU. Latest evidence was reviewed for guideline establishment. A specific screening tool, Padua Prediction Score, was chosen to screen the risk of VTE. Liaison had been made with the ward staffs and the hospital management for program development, budget planning and intermittent pneumatic compression (IPC) devices procurement. Guidelines and role delineation among different professions were set up. Education on program implementation and monitoring was delivered to empower all levels of ward staffs. Doctors and physiotherapists conducted the screening for risk of VTE on patient admission. Physiotherapists prescribed IPC devices for high-risk individuals, and advocated mobility and physical activities for all ASU patients. Nurses closely monitored skin and circulation of patients on 24-hour IPC services. A pilot program was started in November 2016 and had been extended to full implementation in ASU since April 2017.
Result & Outcome :
All patients admitted to ASU were screened for VTE. From April to July 2017, 339 stroke patients were screened. Thirty-eight percent of them were classified under high-risk group and 19% were indicated of IPC. No adverse effect was reported.
The incident rate of VTE during hospitalization decreased from 0.37% among 1095 patients (April 2016 to March 2017) to 0.09% among 1107 patients (April 2017 to March 2018).
This collaborative VTE prevention program for acute stroke patients achieved good anticipated outcomes. It is recommended to generalize this model of care to other neurological units.
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