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Query: UMLS:C0149871 (deep vein thrombosis)
 12,364 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The high treatment costs of inappropriate leg ulcer management are well referenced. Wide variations in practice have also been reported. A training programme for community nurses has been in place in Leicestershire and Rutland NHS Trust for five years. Its objective is to promote evidence-based leg ulcer management. The aim of this prospective audit was to assess and compare the effectiveness of the compression bandage systems used in the trust: the original Charing Cross system (August 1996 to September 1997) and Robinson's Ultra Four kit (October 1997 to December 1998). All patients with leg ulceration were assessed using the Leicestershire leg ulcer assessment form. This was submitted along with an audit tool to the tissue viability service in exchange for a 12-week supply of compression bandages. The audit form was resubmitted after each subsequent 12-week period until the patient either had healed or was withdrawn from the audit. Differences between the two groups in mobility, previous deep vein thrombosis, fixed ankle deformity, the male to female ratio, duration of ulcer and ulcer surface area were noted. Patients using the Ultra Four kit had faster healing times than those given the Charing Cross system, but this was not statistically significant. Cost comparisons between the previous dressing regimen and compression bandaging showed a significance difference (p < 0.001). There was also a significant reduction in nurse time (p < 0.001). The audit results showed that compression bandaging therapy was an effective method of achieving healing in patients with venous leg ulcers and that significant cost savings were made in terms of dressing cost and nurse time. Furthermore, there were potential benefits in continuing compression therapy for the group of non-healers.
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PMID:Developing skills in leg ulcer nursing: the lessons learned. 1193 54

The traditional management of patients with suspected deep vein thrombosis required hospital admission for diagnostic investigation and anti-coagulation therapy. Since November 2001 all patients with suspected DVT at Tameside and Glossop Acute Services NHS Trust have been managed as outpatients via the vascular studies unit according to agreed protocols. Audit results have shown that the service has resulted in a reduction in bed occupancy for patients with a sole diagnosis of DVT, and a reduction in the cost of managing and treating patients with a suspected DVT.
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PMID:A nurse-led outpatient service for patients with DVT. 1261 7

This article highlights the need to use graduated compression stockings (GCS) in deep vein thrombosis (DVT) prophylaxis. A survey carried out at the Middlesex Hospital, part of the UCLH NHS Trust, London, ascertains the prevalence of patients wearing either above- or below-knee GCS and whether or not these were worn correctly through two trials. The findings show how the choice of product can influence compliance, safety and economy, which in turn influences adherence to hospital policy.
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PMID:A new anti-embolism stocking. Use of below-knee products and compliance. 1570 76

We prospectively assessed the implementation of venous thromboembolism (VTE) prophylaxis guidelines and the impact of grand round presentation of the data in changing clinical practice. Two NHS teaching hospitals were studied for 24 months from January 2003. Patients were risk stratified according to the THRIFT (thromboembolic risk factor) consensus group guidelines and compared with the recommendations of the THRIFT and ACCP (American College of Chest Physicians) consensus groups. Six months following presentation of the initial results, a further analysis was made to assess changes in clinical practice. 1128 patients were assessed of whom 1062 satisfied the inclusion criteria for thromboprophylaxis. 89% of all patients were stratified as having high or moderate risk of developing VTE. Of these only 28% were prescribed some form of thromboprophylaxis-4% received the THRIFT-recommended and 22% received the ACCP-recommended thromboprophylaxis. The vast majority (72%) received no thromboprophylaxis at all. Reassessment, following data presentation at grand rounds, showed a significant increase to 31% inpatients receiving THRIFT (P<0.0001) and ACCP (P=0.002) recommended thromboprophylaxis. However,the proportion of patients receiving no form of prophylaxis barely changed (72% to 69%: P=0.59). We found a gross underutilization of thromboprophylaxis in hospitalized medical patients. A simple grand-round presentation of the data and recommended guidelines to clinicians significantly increased the proportion of patients receiving recommended thromboprophylaxis but did not increase the overall proportion of patients receiving it. We therefore conclude that a single presentation of guidelines is not enough to achieve the desired levels. Such presentations may only serve to make DVT (deep venous thromboembolism) aware clinicians prescribe prophylaxis more accurately.
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PMID:Venous thromboprophylaxis in UK medical inpatients. 1638 46

Patients in the Wirra with a suspected DVT can now be diagnosed and treated in a nurse-led centre. The service has reduced waiting times and unnecessary hospital admissions. The service is a collaboration between two primary care trusts and Wirral Hospital NHS Trust. Patients can be referred directly to the walk-in centre by GPs or A&E departments. They can also self-refer. In the first year of the service, the clinic treated 1,600 patients. Nurses take a full history and can order diagnostic tests. Before the service began, 900 patients a year were admitted with a suspected DVT, more than half unnecessarily.
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PMID:No waiting in vein. 1632 Sep 58

Deep vein thrombosis and pulmonary embolism are a major cause of hospital admissions. This article examines the way patients can be treated in an outpatient setting and how this can improve the patient's quality of life as well as provide cost benefits to the NHS.
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PMID:Shifting pulmonary embolism management to primary care. 1649 84

Anti-embolism stockings are widely advocated in the prevention of deep vein thrombosis. But do they do more harm than good? This article explores the effectiveness of this intervention and the possible link with heel pressure ulceration, an increasing problem which costs the NHS millions of pounds and causes suffering to patients. With the aid of an audit tool the author assesses nursing knowledge and reveals that, although there is a high level of understanding regarding post-application care, the appropriate initiation of the intervention and subsequent documentation of this intervention are severely lacking, leaving the health profession wide open to litigation.
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PMID:Anti-embolism stockings: are they used effectively and correctly? 1662 62

This paper reports a prospective audit, against an existing baseline standard, for intermittent pneumatic compression (IPC) in the prophylaxis of asymptomatic deep vein thrombosis (DVT). This was done via a structured questionnaire, using the methodology of total population sampling, encapsulating all theatre staff within one NHS trust. With regards to the standard, performance is good, as IPC is DVT prophylaxis of choice in the perioperative area and is used frequently on most patients. The findings of the audit do, however, highlight the need for appropriate local DVT risk assessment guidelines, essential to ensure that prophylaxis is administered to the correct at risk groups, as prevention may be unjustified in low risk groups and possibly inappropriate for the same regimen to be used for all patients.
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PMID:An audit of intermittent pneumatic compression (IPC) in the prophylaxis of asymptomatic deep vein thrombosis (DVT). 1836 69

In 2005-6, the NHS Litigation Authority (NHSLA) reported 40 claims of wrong site surgery, at a financial cost in excess of GBP1 million and unquantifiable and unimaginable emotional, physical and social cost to those directly affected. While wrong site surgery is described as relatively rare within the UK when set against the total number of procedures performed, when further considered under the wider umbrella of 'surgical harm' (which includes surgical site infection, patient identification errors, drug errors, failures in appropriate DVT/PE prophylaxis, etc) we are experiencing a worrying trend of increasing harm and patient failure.
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PMID:Building a safety culture. 1857 87

Patient positioning in theatre pertains to how a patient is transferred and positioned for a specific procedure. Patient safety is a central focus of care within the NHS and every healthcare practitioner must ensure that patients are protected from harm where possible. Mal-positioning of the patient has important implications in terms of associated problems of pressure sores, nerve compressions, deep vein thrombosis and compartment syndrome, and should be avoided.
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PMID:The importance of correct patient positioning in theatres and implications of mal-positioning. 2044 25


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