1 research outputs found
Primjena smjernica za profilaksu venske tromboembolije u kliniÄkoj praksi: retrospektivno istraživanje u dvjema hrvatskim bolnicama
The aim of this study was to evaluate the implementation of the 9th edition of the American College of Chest Physicians (ACCP9) guidelines for prevention of venous thromboembolism in nonsurgical patients in clinical practice in one university and one general Croatian hospital. A retrospective study was conducted at Zadar General Hospital from Zadar and Dubrava University Hospital from Zagreb. Medical charts of all patients admitted to Medical Departments in two periods, before and after implementation of the ACCP9 guidelines, were analyzed. The ACCP9 guidelines were made available to all physicians through the hospital electronic information system immediately after the publication. The Hospital Drug Committees promoted implementation of the guidelines during their periodical clinical visits. Overall, 850 patients were included in the study in two periods. There was no statistically significant difference in the number of high-risk patients receiving thromboprophylaxis after the guidelines implementation in either hospital. In both periods, a signifi-cantly higher number of high-risk patients received thromboprophylaxis in Dubrava University Hos-pital in comparison with Zadar General Hospital (31.7% vs. 3.8% and 40.3% vs. 7.3%, respectively; p<0.001). This study revealed insufficient implementation of evidence-based thromboprophylaxis guidelines in clinical practice in two Croatian hospitals.Cilj ovoga retrospektivnog istraživanja bio je procijeniti primjenu 9. izdanja smjernica American College of Chest Physicians (ACCP9) za prevenciju venske tromboembolije u nekirurÅ”kih bolesnika u kliniÄkoj i opÄoj bolnici u Republici Hrvatskoj. Istraživanje je provedeno u OpÄoj bolnici Zadar i KliniÄkoj bolnici Dubrava u Zagrebu. Analizirana je medicin-ska dokumentacija svih bolesnika hospitaliziranih na internistiÄke odjele u razdoblju prije i nakon implementacije smjernica ACCP9. Smjernice su bile dostupne svim lijeÄnicima putem bolniÄkih informatiÄkih sustava. BolniÄka povjerenstva za lijekove su Ātijekom periodiÄkih kliniÄkih vizita promovirala primjenu smjernica u kliniÄkoj praksi. U razdoblju prije i nakon implementacije smjernica u istraživanje je ukljuÄeno ukupno 850 bolesnika. Niti u jednoj bolnici nije bilo statistiÄki znaÄajne razlike u broju visoko riziÄnih bolesnika koji su dobili tromboprofilaksu nakon implementacije smjernica. U oba razdoblja je broj Āvisoko riziÄnih bolesnika koji su dobili tromboprofilaksu bio znaÄajno veÄi u KliniÄkoj bolnici Dubrava u odnosu na OpÄu bolnicu Zadar (31,7% prema 3,8% i 40,3% prema 7,3%; p<0,001). Rezultati istraživanja ukazuju na nedostatnu implementaciju smjernica za tromboprofilaksu u dvjema hrvatskim bolnicama