Audit

of VenousTHROMBOEMBOLISM
Thromboembolism Prevention
AUDIT
OF VENOUS
PREVENTION
Purpose: To determine compliance in providing venous thromboembolism (VTE) prophylaxis to at-risk patients. To
determine incidence of VTE and pulmonary embolism.
Instructions: Answer each question by checking the appropriate boxes. Review documentation for a 24-hour period.
Date: _____________ Time: ___________ Room number: ________
Bedside Nurse: ___________________________ Auditing Nurse: __________________________

1. Patient VTE risk identified on admission to unit:

Yes
No, explain: ________________________________
2. Appropriate VTE prophylaxis initiated:
Yes
No, explain: _________________________________
Not applicable, patient not at risk
3. Patient developed VTE or pulmonary embolism after admission to unit:
VTE, location ________________________________
Pulmonary embolism
No

Avoid auditing documentation for patients not on the unit for the majority of the 24 hour period (patients who were
just admitted, who were off the unit for extended periods for testing/procedures, etc).

1 of 1

Issued 4/2010
B. Martin