The prevention and management of VTE in care homes: currents standards in England (December 2016)

Summary

Venous thromboembolism (VTE) is a condition in which a thrombus – a blood clot – forms in a vein. Usually, this occurs in the deep veins of the legs and pelvis and is known as deep vein thrombosis (DVT). The thrombus or its part can break off, travel in the blood system and eventually block an artery in the lung. This is known as a pulmonary embolism (PE). VTE is a collective term for both DVT and PE.

With an estimated incidence rate of 1-2 per 1,000 of the population, VTE is a significant cause of mortality and disability in England with thousands of deaths directly attributed to it each year. One in twenty people will have VTE during their lifetime and more than half of those events are associated with prior hospitalisation.

At least two thirds of cases of hospital-associated thrombosis are preventable through VTE risk assessment and the administration of appropriate thromboprophylaxis.

Content

These are the recommendations following the review of current VTE standards in UK Care homes.

1.Further academic research should be conducted to clinically establish the extent to which care home residents in England are at an increased risk of preventable blood clots, and what the appropriate threshold for thromboprophylaxis should be.

2. The CQC should develop national guidance on prevention and management of VTE in the care home setting, closely informed by the latest academic research on the risk of VTE in care homes in England.

3. All hospitals should include a mandatory section on VTE risk in their discharge summaries, indicating instructions on the steps that should be taken to manage the patient’s risk.

4. CCGs should work with local secondary, primary and social care providers to develop local transfer of care protocols to facilitate smooth transfer of care between hospitals and care homes and clarify procedures for managing patients’ VTE risk post-discharge.

5. CCGs should develop community-based VTE treatment pathways for occurrences and recurrences of VTE in the care home setting to relieve capacity pressure on hospitals and ensure timely treatment.