RCN in Wales gives evidence to VTE inquiry

Published: 29 May 2012

National Assembly for Wales Health and Social Care Committee Inquiry into venous thrombo-embolism prevention (VTE) in hospitalised patients in Wales: Royal College of Nursing in Wales gives evidence

The Royal College of Nursing in Wales gave evidence to the National Assembly for Wales Health and Social Care Committee Inquiry into venous thrombo-embolism prevention (VTE) in hospitalised patients in Wales.

Venous relates to veins and thrombosis is a blockage of a blood vessel by a thrombus (a blood clot). When a thrombus dislodges from where it is formed, travels through the venous system and lodges itself in an artery causing a blockage, this is called an embolism. Venous thrombosis can form in any part of the venous system but deep vein thrombosis (DVT) (the formation of a thrombus in the deep veins of the body, usually the leg) and the thrombus then dislodging itself from the leg and travelling through the venous system to lodge itself in the lung to cause a pulmonary embolism (PE) is the most common. The collective term for DVT and PE is venous thrombo-embolism (VTE).

VTE is a very serious condition and can be acquired in a community or hospital setting. It is estimated that two thirds of thrombosis deaths are caused by hospital-acquired thrombosis. Up to one in every 1,000 are affected by venous thrombosis in the UK every year.

The development of the 1000 Lives Plus risk assessment tool in Wales in 2010 was a tremendous achievement and justly celebrated. Unfortunately since its initial launch the VTE programme has now a low key maintenance approach. The assessment tool is being used inconsistently across Wales. Some areas are using the tool however many are not. This poor uptake is inconsistent within Local Health Boards (LHBs) and indeed is inconsistent within hospitals.

Nicola Davis-Job, Acute Care and Leadership Adviser at RCN Wales who gave evidence at the inquiry said: "Some Local Health Boards have employed a specialist nurse (often as a part-time aspect of their role) to monitor VTE prevention. A specialist nurse is employed in Abertawe Bro Morganwg University LHB and in Betsi Cadwaladr. A specialist nurse is also employed specifically for Glan Clwyd Hospital but funded by a pharmaceutical company – the funding of which is coming to an end. These nurses are crucial to provide education to healthcare support workers, junior doctors and nurses on the subject. This approach is clearly inconsistent across Wales. It would make sense to consider the evidence from these posts – including the financial cost-benefit analysis. If the impact of uptake and education can clearly be seen to improve and the rate of VTE reduced the wisdom of securing the future of these posts is clear."