scholarly journals Venous thromboembolism risk in psychiatric in-patients: a multicentre cross-sectional study

2019 ◽  
Vol 43 (6) ◽  
pp. 255-259
Author(s):  
Natalie Ellis ◽  
Carla-Marie Grubb ◽  
Sophie Mustoe ◽  
Eleanor Watkins ◽  
David Codling ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Venous Thromboembolism ◽  
Assessment Tool ◽  
Psychiatric Patients ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Vte Prophylaxis ◽  
Increased Risk ◽  
The Uk

Aims and methodWe assessed venous thromboembolism (VTE) risk, barriers to prescribing VTE prophylaxis and completion of VTE risk assessment in psychiatric in-patients. This was a cross-sectional study conducted across three centres. We used the UK Department of Health VTE risk assessment tool which had been adapted for psychiatric patients.ResultsOf the 470 patients assessed, 144 (30.6%) were at increased risk of VTE. Patients on old age wards were more likely to be at increased risk than those on general adult wards (odds ratio = 2.26, 95% CI 1.51–3.37). Of those at higher risk of VTE, auditors recorded concerns about prescribing prophylaxis in 70 patients (14.9%). Only 20 (4.3%) patients had a completed risk assessment.Clinical implicationsMental health in-patients are likely to be at increased risk of VTE. VTE risk assessment is not currently embedded in psychiatric in-patient care. There is a need for guidance specific to this population.

Assessing the risk of venous thromboembolism in psychiatric in-patients

2017 ◽  
Vol 41 (S1) ◽  
pp. S686-S686
Author(s):  
N. Ellis ◽  
M. Quraishy ◽  
C.M. Grubb ◽  
S. Fitch ◽  
J. Harrison
Keyword(s):  
Risk Assessment ◽  
Venous Thromboembolism ◽  
Assessment Tool ◽  
Psychiatric Patients ◽  
Health Board ◽  
Compression Stockings ◽  
Vte Prophylaxis ◽  
Increased Risk ◽  
Competing Interest ◽  
The Uk

IntroductionVenous thromboembolism (VTE) is a potentially fatal condition. Hospital-associated VTE leads to more than 25,000 deaths per year in the UK. Therefore identification of at-risk patients is crucial. Psychiatric in-patients have unique factors which may affect their risk of VTE (antipsychotic prescription, restraint) however there are currently no UK guidelines which specifically address VTE risk in this population.ObjectivesWe assessed VTE risk among psychiatric inpatients in Cardiff and Vale university health board, Wales, UK, and whether proformas currently provided for VTE risk assessment were being completed.MethodsAll acute adult in-patient and old age psychiatric wards were assessed by a team of medical students and a junior doctor over three days. We used the UK department of health VTE risk assessment tool which was adapted to include factors specific for psychiatric patients. We also assessed if there were concerns about prescribing VTE prophylaxis (compression stockings or anticoagulants), because of a history of self-harm or ligature use.ResultsOf the 145 patients included, 0% had a completed VTE risk assessment form. We found 38.6% to be at an increased risk of VTE and there were concerns about prescribing VTE prophylaxis in 31% of patients.ConclusionsOur findings suggest that VTE risk assessment is not being carried out on psychiatric wards. Staff education is needed to improve awareness of VTE. Specific guidance for this population is needed due to the presence of unique risk factors in psychiatric in-patients and concerns regarding VTE prophylaxis.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Prevalence and correlates of domestic violence among people seeking treatment for self-harm: data from a regional self-harm register

2019 ◽  
pp. emermed-2018-207561
Author(s):  
Tom Rollo Dalton ◽  
Duleeka Knipe ◽  
Gene Feder ◽  
Salena Williams ◽  
David Gunnell ◽  
...  
Keyword(s):  
Emergency Department ◽  
Domestic Violence ◽  
General Population ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Increased Risk ◽  
Self Harm ◽  
The Uk ◽  
Previous Occurrence

BackgroundPrevious research suggests that there is an association between domestic violence (DV) and self-harm (SH). Yet, the prevalence and clinical significance of DV among individuals presenting acutely to hospital with SH in the UK is unknown.ObjectiveTo measure the prevalence and correlates of DV among patients presenting to hospital with SH.MethodsWe conducted a cross-sectional study using registry data in order to describe the prevalence of DV within a UK population of people presenting to the emergency department (ED) with SH (n=1142).Results11.1% (95% CI 9.4% to 13.1%) of the sample reported DV. Those reporting DV were more likely to be female and separated from a partner. DV was associated with self-poisoning and with previous occurrence of SH.ConclusionOur findings suggest that DV victimisation is more prevalent among those presenting to ED with self-harm than among the general population of ED attenders, and that the presence of DV may signify increased risk among those presenting to ED with SH.

scholarly journals EP.FRI.495 A retrospective audit of electronic venous thromboembolism risk assessment compliance across three surgical wards in a district general hospital

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Tavlene Banwaith ◽  
Mohammed Kaif Qayum ◽  
Chokkalingam Arun ◽  
Ghulam Nawaz
Keyword(s):  
Risk Assessment ◽  
Venous Thromboembolism ◽  
Assessment Tool ◽  
District General Hospital ◽  
Risk Assessments ◽  
Cross Sectional ◽  
Vte Prophylaxis ◽  
Retrospective Audit ◽  
The Mean ◽  
Audit Cycle

Abstract Aims Venous thromboembolism (VTE) is the leading cause of preventable hospital deaths; with hospital-acquired VTEs accounting for 50% to 60% of all VTEs seen. This project aims to review and improve the number of VTE risk assessments completed for surgical in-patients. Methods This retrospective, cross-sectional study involved data collection from surgical in-patients (n = 648) over three consecutive months, using an electronic VTE risk assessment tool. Data was categorised into ‘First VTE prophylaxis risk assessment completed within 24 hours of admission’ and ‘Second VTE prophylaxis risk assessment completed within 48 hours of admission’. This was further sub-categorised into surgical specialties. Results were presented in departmental meetings and educational posters were displayed. The study was re-audited using the same method over one month (n = 216). Results Results demonstrated improvement from the initial audit cycle, particularly in relation to the mean number of VTE risk assessments completed for patients undergoing breast surgery (100% from 95.3%), colorectal surgery (93.3% from 90%) and general surgery (88.0% from 86.6%). The mean number of first VTE risk assessments completed in 24 hours across all surgical wards remained above 65%, whilst the mean number of second VTE risk assessments completed in 48 hours improved from 36.1% to 47.6%. Conclusions Variation in compliance is still evident across the surgical in-patient wards. Going forward, responsibility to complete outstanding VTE risk assessments will be handed to the FY1 on the late shift. Following this intervention, a further audit cycle will be performed, with the aim of 100% compliance in VTE risk assessment completion.

scholarly journals Thrombosis and embolism in pregnancy and the puerperium, reducing the risk: what proportion of patients reach the threshold for thromboprophylaxis?

2011 ◽  
Vol 4 (1) ◽  
pp. 12-14 ◽  
Author(s):  
Bethany J Revell ◽  
Richard P Smith
Keyword(s):  
Risk Assessment ◽  
Royal College ◽  
Assessment Tool ◽  
Cross Sectional Study ◽  
Risk Assessment Tool ◽  
Published Data ◽  
Sectional Study ◽  
Cross Sectional ◽  
In Pregnancy

In November 2009 the Royal College of Obstetricians and Gynaecologists published an updated guideline, ‘Reducing the risk of thrombosis and embolism during pregnancy and the puerperium’. This includes a clear and simple score-based risk assessment tool, designed for antenatal and postnatal patients. Thresholds are given at which thromboprophylaxis should be offered. However the proportion of patients who reach the threshold is not estimated in the guideline, and we are not aware of any published data regarding this. In this cross-sectional study, we studied the case-notes of all 109 deliveries conducted over a one-week period, including elective caesarean sections. Of those, 7% met the threshold for antenatal thromboprophylaxis and 41% met the threshold for postnatal thromboprophylaxis.

scholarly journals SARS-CoV-2 seroprevalence and asymptomatic viral carriage in healthcare workers: a cross-sectional study

Thorax ◽  
2020 ◽  
Vol 75 (12) ◽  
pp. 1089-1094 ◽  
Author(s):  
Adrian Shields ◽  
Sian E Faustini ◽  
Marisol Perez-Toledo ◽  
Sian Jossi ◽  
Erin Aldera ◽  
...  
Keyword(s):  
Intensive Care ◽  
Healthcare Workers ◽  
Venous Blood ◽  
Cross Sectional Study ◽  
Nasopharyngeal Swab ◽  
Sectional Study ◽  
University Hospitals ◽  
Cross Sectional ◽  
General Internal ◽  
Increased Risk

ObjectiveTo determine the rates of asymptomatic viral carriage and seroprevalence of SARS-CoV-2 antibodies in healthcare workers.DesignA cross-sectional study of asymptomatic healthcare workers undertaken on 24/25 April 2020.SettingUniversity Hospitals Birmingham NHS Foundation Trust (UHBFT), UK.Participants545 asymptomatic healthcare workers were recruited while at work. Participants were invited to participate via the UHBFT social media. Exclusion criteria included current symptoms consistent with COVID-19. No potential participants were excluded.InterventionParticipants volunteered a nasopharyngeal swab and a venous blood sample that were tested for SARS-CoV-2 RNA and anti-SARS-CoV-2 spike glycoprotein antibodies, respectively. Results were interpreted in the context of prior illnesses and the hospital departments in which participants worked.Main outcome measureProportion of participants demonstrating infection and positive SARS-CoV-2 serology.ResultsThe point prevalence of SARS-CoV-2 viral carriage was 2.4% (n=13/545). The overall seroprevalence of SARS-CoV-2 antibodies was 24.4% (n=126/516). Participants who reported prior symptomatic illness had higher seroprevalence (37.5% vs 17.1%, χ2=21.1034, p<0.0001) and quantitatively greater antibody responses than those who had remained asymptomatic. Seroprevalence was greatest among those working in housekeeping (34.5%), acute medicine (33.3%) and general internal medicine (30.3%), with lower rates observed in participants working in intensive care (14.8%). BAME (Black, Asian and minority ethnic) ethnicity was associated with a significantly increased risk of seropositivity (OR: 1.92, 95% CI 1.14 to 3.23, p=0.01). Working on the intensive care unit was associated with a significantly lower risk of seropositivity compared with working in other areas of the hospital (OR: 0.28, 95% CI 0.09 to 0.78, p=0.02).Conclusions and relevanceWe identify differences in the occupational risk of exposure to SARS-CoV-2 between hospital departments and confirm asymptomatic seroconversion occurs in healthcare workers. Further investigation of these observations is required to inform future infection control and occupational health practices.

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