BLOOD CLOTS

Venous thromboembolism

Blood clots are the cause of the greatest number of preventable hospital deaths (Lifeblood 2010). Hospital-acquired blood clots claim an estimated 25,000 deaths each year, accounting for one in 10 deaths in hospital (Lifeblood 2010). Evidence suggests that the perception that thrombosis is a condition only affecting older people is false. The Lifeblood charity has obtained data from the Office of National Statistics which show that deaths in the under 50s have reached nearly 3,000 between 2005 and 2008 (Lifeblood 2010). Despite the impact of hospital-acquired and community-acquired thrombosis little direct funding is available to tackle blood clot prevention.

The research evidence around assessment and appropriate prophylaxis of venous thromboembolism (VTE) has been evaluated by NICE (National Institute for Health and Clinical Excellence 2010a) which will also produce a related Quality Standard (National Institute for Health and Clinical Excellence 2010b). The Academy of Medical Royal Colleges (2010) has pledged to reduce the number of avoidable deaths from VTE in the UK. The joint action recommended by the Department of Health, strategic health authorities and professional leads includes assessment of risk in primary care at time of referral to hospital. It also recommends setting systems to ensure VTE assessment, regular audit of patients risk-assessed for VTE, and reinforcement of the importance of VTE through educational programmes (Academy of Medical Royal Colleges 2010; Keogh 2010). The RCN's patient safety resource will provide a place for material about VTE which will be updated as the RCN's contribution to the UK wide programme progresses.

The RCN has mapped available UK learning and development material on VTE: http://www.rcn.org.uk/development/practice/patient_safety/vte

24/7 THROMBOLYSIS FOR STROKES

Tuesday 6 October 2009 saw the launch of the 24/7 thrombolysis service for patients at Basildon and Thurrock University Hospital, due to the appointment of 2 new consultants, the support of the Cardiac and Stroke network and partnership working with the Stroke Rehab Unit, Radiology and NHS South West Essex. Pasteur ward is now a dedicated acute stroke unit.
Not all patients are suitable for the treatment as it depends on the severity and cause of the stroke, whether by a bleed or blood clot. Assessments, including a CT scan, have to be carried out before treatment.
The drug is only licenced for patients between 18 and 80 and they have to be thrombolysed within 3 hours of the first sign of a stroke. The drugs minimise the damage caused to the brain and helps prevent lasting disabilities by dissolving the blood clot.
It is hoped the service will go from strength to strength.