A venous thromboembolism (VTE) prevention protocol is a standardized VTE risk assessment, linked to a menu of appropriate VTE prophylaxis options for each level of risk, which provides guidance for management of patients with contraindications to pharmacologic prophylaxis. Bleeding risk tools and guidance for the timing of administering anticoagulant prophylaxis around surgical procedures or other high bleeding risk intervals should also be part of a protocol.
Protocols define best practice at the local level based on the best evidence available, with operational definitions that focus on measurement tools and other aspects. Unfortunately, opinions vary on a preferred VTE risk assessment tool. VTE risk assessment is essentially a tool. Patients are targeted for interventions to prevent VTE (anticoagulant or mechanical prophylaxis and efforts to improve mobility) based on the assessment of risk of a VTE event. A healthcare professional must weigh the potential benefit of identifying a VTE with the possible discomfort, expenses and other adverse effects that could result from the prophylactic measures.
VTE risk assessment tools include, but are not limited to, the following:
- NHS / NICE Risk Assessment for VTE
- Padua Model
- The IMPROVE (International Medical Prevention Registry on Venous Thromboembolism) Model
- Caprini Model
- Wells Score
- Australian and New Zealand Working Party on Management of Venous Thromboembolism
- Italian Model