James Paget University Hospital |
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This District General Hospital situated on the most easterly part of the United Kingdom serves a population of 240,000. In an area of relatively high deprivation the hospital has a history of successful development, most recently in August 2006 the Trust not only achieved Foundation status but also was recognised as a University hospital for it contribution to the University of East Anglia. With the focus of health care standard shifting from quantitative to qualitative standard it has continued to show success with such awards as the best cleaned hospital for 2007 and seen as a national leader in the prevention and management of Clostridium Difficile infection. Since 1999 there have been nurse specialists for anticoagulation that have developed a robust services deep vein thrombosis diagnosis and treatment; and people requiring anticoagulation therapy. The system is so effective that all anticoagulation therapy for the Primary Care Trusts is co-ordinated through this service, a total of 3,500 patients. Auditing of compliance to venous thromboembolism prevention measures has also been long part of the anticoagulation service and results in 2003, 2004 and 2006 were well below standard. With this heritage and the pre-emption of the Chief Medical Officer's statement in 2007 a venous thromboembolism prevention committee was formed. With the appreciation that this was an issue to which all areas of the Trust were responsible the membership reflected this with medical, nursing, pharmacy and management representation. Working on local, national and international guidance the committee formulated documentation that encompassed the Trust, and provides both risk assessment and guidance. As part of this process the Trust has changed to an "opt-out" strategy, with emphasis upon delivery of prophylaxis as soon as is feasible along with fail safe mechanism to improve compliance. The broad membership of the committee also allowed effective implementation of the guidance, and with continued dialogue with all clinical areas the guidance has already undergone updates within the first year of use. The Trust has, by various means, an attitude of continued review of compliance and feedback directly to all clinical staff. Areas of weakness have been identified an action plans already devised. Further the Trust provides continued education concerning this issue to all disciplines and levels of seniority.
For further information, please contact Dr Guy Vautier, Consultant Physician.
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