Assessing if VTE risk assessment is completed in patients admitted to an old-age psychiatric ward

Patients admitted to psychiatric inpatient units are at increased risk of developing venous thromboembolism (VTE), and according to National Institute for Health and Care Excellence guideline NG89 , all patients should undergo VTE risk assessment as soon as possible following admission, as this leads to fewer deaths and shorter hospital stays. In a male old-age psychiatric inpatient unit at Reservoir Court, policy required VTE assessment within 72 hours of admission.

This audit aimed to assess compliance with VTE risk assessment within 72 hours, determine whether appropriate prophylaxis was prescribed when indicated, identify reasons for omission of prophylaxis, and evaluate whether VTE risk was formally discussed within multidisciplinary team (MDT) meetings.

Data were collected retrospectively using the RiO electronic patient record system for 69 patients admitted between 27 December 2023 and 29 January 2026. Information collected included admission dates, reasons for admission, timing and location of VTE risk assessments, and subsequent management decisions.

Overall, 69.6% (48/69) of patients underwent VTE risk assessment within 72 hours. 10 patients were assessed after 72 hours, while 11 received no assessment. Among patients assessed within 72 hours, 83.3% (40/48) were classified as not at risk, whilst 16.7% (8/48) required prophylaxis. Of these, six received prophylaxis, predominantly anticoagulants including apixaban and rivaroxaban, with one patient receiving compression stockings alone, and another receiving both stockings and rivaroxaban. Two patients developed VTE during the audit period despite timely assessment and appropriate prophylaxis.

Key barriers identified included fragmented record-keeping, incomplete documentation, limited staff awareness regarding assessment records, and poor communication of outcomes to consultants and MDTs. Improvements in record organisation, staff training, and structured MDT discussion are recommended to improve compliance and patient safety.