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Practice comment 

Nurses are key to ensuring that patients are assessed for VTE risk

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VTE awareness and education for nurses of all levels is essential for successful implementation of the government’s prevention strategy, argues Lynda Bonner


In February this year, chief nursing officer for England Chris Beasley identified nurses as being at the centre of a national strategy to prevent venous thromboembolism (VTE).

The chief medical officer for England, Sir Liam Donaldson, and the all-party parliamentary thrombosis group held a VTE leadership summit in June, to raise awareness of the Department of Health’s prevention strategy.

The CMO identified VTE prevention as a major patient safety issue and acknowledged that it had been overlooked as a priority for too long. As part of this summit, a resource document (Arya, 2009) was issued.

The document covers aspects of raising awareness and education on VTE prevention. It describes a vision of VTE risk assessment and thromboprophylaxis becoming the norm, as part of routine nursing practice.

However, if this vision is to be realised, there is a need for awareness of the seriousness of the problem and its related morbidity and mortality among all healthcare professionals, patients and the public.

The challenge in raising awareness among nurses is to ensure that practitioners at all levels know what is required of them to prevent VTE.

At the VTE leadership summit, Dr Roopen Arya, director of the King’s Thrombosis Centre, said there was a need to establish VTE nurse consultant posts, because of the level of nursing expertise needed to address the issue.

These nurse consultants would be expected to influence national and local policy, conduct novel research on VTE prevention, establish nursing VTE metrics, set up regular audits and disseminate best practice.

Potential benefits of funding such posts should become evident from audits showing increased VTE risk assessment and appropriate thromboprophylaxis.

Senior nurses or VTE clinical nurse specialists can ensure that: thrombosis committees are formed to provide leadership for VTE prevention; a team of VTE link nurses is formed to act as local champions; and risk assessment and appropriate thromboprophylaxis are included as a key performance indicator in trust clinical scorecards.

These nurses can also apply for ‘VTE exemplar centre’ status which serves as a quality mark for good practice (see the King’s Thrombosis Centre for more information).

Nurses in direct contact with patients, whether on the wards or in pre-assessment clinics, need to be aware that they have a responsibility to ensure that patients are assessed for VTE risk, and that appropriate thromboprophylaxis is prescribed by an appropriate clinician.

The challenge in raising awareness among nurses is to ensure that practitioners at all levels know what is required of them to prevent VTE.

Education is vital if nurses are to feel competent in VTE prevention care. The resource document includes contributions from the ‘Map of Medicine’ project (a web-based tool), which has published a VTE prevention pathway and is available via the NHS Choices website.

The most exciting development in education comes in the form of e-VTE, a learning resource. This tool, developed by the VTE implementation working group in partnership with e-Learning for Healthcare, a Department of Health programme, was launched at the leadership summit.

This is an excellent resource easily and freely accessible to anyone with an interest in the issue.

Education on VTE prevention should become part of the mandatory and foundation training for all nurses.

VTE prevention awareness and education for nurses at all levels are necessary for successful and ongoing implementation of the prevention strategy. The importance of VTE prevention has been overlooked for too long.

The VTE leadership summit and the resource document are an excellent opportunity to review the progress made in forming a national VTE prevention programme and to plan the way forward in raising awareness and tackling the problem.

Lynda Bonner is coagulation nurse specialist at King’s College Hospital NHS Foundation Trust, the first NHS exemplar centre for VTE prevention.

For more information on VTE exemplar centres, see the King’s Thrombosis Centre.



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