Hospitals in Colchester have been awarded "exemplar centre" status by the Government for their work to protect patients from potentially fatal hospital acquired blood clots.

Colchester Hospital University NHS Foundation Trust, which runs Colchester General Hospital and Essex County Hospital, has become only the fifth NHS hospital trust to achieve the prestigious accreditation.

Among the measures taken by the Trust are:

• Development of a protocol in conjunction with its consultants and pharmacy staff in line with NICE guidance and the demands of the Government's Chief Medical Officer Sir Liam Donaldson
• An e-learning tool for doctors and nurses who treat hospital inpatients, who are at risk of acquiring blood clots
• Development of what is believed to be the only online risk assessment tool in the NHS to identify patients at risk of VTE and which also offers guidance on the steps that should be taken to minimise it
• The use of the Trust's clinical audit department to evaluate and report back on the work to prevent clots.

Our ‘Nurse-Led-Doctors-Complete' VTE risk assessment system (RA) was developed as part of a new programme set up to tackle the difficulties of achieving good compliance levels in VTE prophylaxis in our Trust. It is part of a programme that includes new trust wide VTE protocols, eVTE learning, pre-printed drug chart stickers, online risk assessment, and Audication (rolling audit with immediate educational feedback and emailed league tables for specialities and wards).

In today's NHS, nurses are a constant presence on inpatients wards and unfortunately junior doctors are not. Hence the ‘Nurse-Led-Doctors-Complete' VTE risk assessment system allows seniors nurse to maintain compliance levels of VTE RA and therefore prophylaxis. The nurses, once eVTE trained, notify junior doctors of missing RAs and ask them to complete the RA form (online or on paper). The RA forms are stapled to drug charts for ease of recognition and audit purposed. Once the RA form has been completed the VTE prophylaxis can be given by the nurses, the patient is also now permitted to leave the ward for investigation or intervention.

RA and prophylaxis is also checked on the pre-operative WHO checklist and surgery cannot proceed without them. If junior doctors are not available and a potential delay in patient care my arise then senior eVTE trained nurses can RA, but at present the doctors still have to check and sign the RA forms. In the future we aim to allow DVT prevention nurses and ward nurse leads for patient safety to RA and prescribe, however the system should be led by nurses and the majority of forms completed by doctors (ideally in A+E or Pre-admission Clinics).Page in progress.

For further information, please contact Mr Adam Howard, Consultant Surgeon, Department of Vascular and Laparoscopic Surgery.

Adam.Howard@colchesterhospital.nhs.uk