VENOUS THROMBOEMBOLI SM
our unit needed additional staffing support and training, and the commitment and buy-in of the entire team to offer their time to making the pilot a success. Working with the manufacturer, a training programme was put in place to get staff familiar with the device. Additional staff were also enlisted to ensure regular daily checks were carried out with each patient, and participants received regular follow-ups once they had left the unit. A study of this scale represented a monumental level of commitment and effort from the team, but our priority has always been to provide the best outcomes for patients. Having identified a gap in care and the need for change, and having overcome initial apprehensions regarding a potential modification to practice, there was a collective drive to embrace a new, innovative method to ultimately offer improved treatment for all patients – particularly the at-risk cohort.
Introducing change requires leadership, energy and collaboration. In our case, the close collaboration and support of key stakeholders, including Governance, staff, and most importantly, patients, enabled us to evaluate this new way of preventing VTE.
Pilot results & patient benefit Diligent analysis of the initial 1,000 patient data-set took just under one year – and the
Our data showed that of 463 patients prescribed IPC, 11 patients (2.4%) suffered a VTE event. Of the 203 patients prescribed the Geko device, no incidence of VTE was reported 90 days post-discharge.
incredible effort of the team soon became worthwhile. Of the 1,000 patients, 29.5% were contraindicated or unable to tolerate IPC (this figure is in line with the CLOT3 findings), making them eligible for an alternative anti-stasis intervention – the Geko device. Our data showed that of 463 patients prescribed IPC, 11 patients (2.4%) suffered a VTE event. Of the 203 patients prescribed the Geko device, no incidence of VTE was reported 90 days post-discharge. NICE guidance MTG19 supports use of the device for people who have a high risk of VTE and for whom pharmacological or other mechanical methods of VTE prevention are impractical or contraindicated. The Royal Stoke team has since implemented NICE guidance when IPC cannot be prescribed. Over 90% of patients tolerated the device, which was favourable when compared to patients prescribed IPC. Compliance
feedback was overall very positive, giving reassurance to the unit that this study had been correct and right to pursue. Since sharing these results, our unit has continued with an expansion of the data. There are other stroke units across the country also exploring use of the device to prevent venous stasis, and it’s been gratifying to hear from peers in stroke care who recognise the potential for this study and its benefits to patient recovery and outcomes.
Embracing change and innovation Introducing change to clinical practice to address areas of unmet need is complex, especially within the NHS; from ensuring patient safety to developing a thorough case for investing in new methods or equipment, a number of considerations must be taken into account. It is by no means an easy undertaking, and it takes
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