Venous thromboembolism (VTE) risk screening in residential aged care facilities post-surgery

Aims: Venous thromboembolism (VTE) includes deep vein thrombosis (DVT) and pulmonary embolism (PE). It is a leading cause of morbidity and mortality in the geriatric post-surgical population. Hip fracture patients and those with a protracted post-operative recovery are at higher risk. Despite evidence that risk assessment and thromboprophylaxis as the most effective methods of VTE prevention, there is no identified VTE risk screening tool utilised in the Australian residential aged care sector. This study assessed the use of VTE risk screening protocols and awareness of VTE in residential aged care facilities, including in the higher risk post-surgical patient. Methods: A cross-sectional survey directed at policy managers was distributed via email to providers of all aged care facilities in New South Wales (NSW) and the Australian Capital Territory (ACT) with 10 or more residents. Results: A total of 16.3% (49/301) of providers responded, representing 28.6% (249/871) of aged care facilities and 31.7% (20,958/66,121) of residents in NSW and ACT. A written protocol for VTE risk screening was used by 1.2% (3/249) of facilities, and 79.5% (198/249) were unaware that VTE is an issue in the population. Only 0.8% (2/249) were aware that risk screening and prophylaxis is required to prevent VTE, though none were acting upon this. No facility had specific post-surgical processes for VTE risk assessment or prevention. Conclusion: The majority of residential aged care facilities do not have VTE risk screening protocols and are unaware of the threat that this omission poses, particularly in post-surgical patients.