Assessment of the Knowledge, Practices and Prevention of Venous Thromboembolism in Korle Bu Teaching Hospital

Abstract

Background: Considering the high prevalence of venous thromboembolism (VTE), its complications and mortality, it has become essential to assess the level of knowledge and preventive practices of health workers in Ghana as well as to establish the true profile and prevalence of VTE risk among adult hospitalized patients. General Objective: To assess the VTE knowledge and prevention practices of health workers; and the VTE risk profile (prevalence) among adult hospitalized patients in Korle Bu Teaching Hospital, Accra. Methods: The study employed a quantitative cross-sectional design in studying adult hospitalized patients and health workers in KBTH. Data was collected from 233 health workers and 267 patients in five clinical departments by systematic random sampling, using structured questionnaires and a modified Caprini VTE risk assessment tool. Data was analyzed using descriptive statistics (frequencies, percentages, proportions, means ± SD, median and IQR). Chi square/ Fishers' exact test was used to determine association between two categorical variables e.g. VTE knowledge and profession. Mann-Whitney and Kruskal-Wallis tests were used to compare medians between two or more groups appropriately e.g. VTE risk levels and thromboprophylaxis modalities. Results: The overall mean VTE knowledge score among health workers in KBTH was 51.8%. The average score of doctors was, however, much higher than nurses (68.0% vs. 40.1%, p<0.001). Almost all, 229 (98.7%) of the health workers perceived VTE thrombo-prophylaxis as being clinically important with 85 (82.5%) of prescribers, self-reporting routine or frequent prescription of thrombo-prophylaxis. Low molecular weight heparin (LMWH) (94.2%) was the most prescribed method of thrombo-prophylaxis. The prevalence of high risk of VTE among adult hospitalized patients in KBTH was 47.2%; with significantly higher prevalence in the Intensive Care Unit (ICU) and Accident, Trauma and Orthopaedic patients (76.7% and 61.5%, p<0.001). Thrombo-prophylaxis rate in the hospital was generally low, with LMWH (30.0%) and anti-embolic stockings (28.5%) as the commonest methods used but there was significant departmental association. Conclusion: The VTE knowledge level of health workers in KBTH is generally less than ideal with doctors significantly more knowledgeable than nurses. The self-reported perception and thromboprophylaxis practices of health workers were acceptably good but do not reflect the actual thrombo-prophylaxis received by patients. There was no statistically significant association found between the VTE knowledge level of health workers and their self-reported thrombo-prophylactic practices The prevalence of high risk of VTE among hospitalized adult patients in KBTH is high (47.2%) and is greatest at the ICU and Accident, Trauma and Orthopaedic patients.