Venous Thromboembolism Risk Assessment in Renal Transplant Patients at the Queen's Medical Center in Hawaiʻi

Abstract

Introduction Venous thromboembolism (VTE) is a common post-operative renal transplant complication. VTEs are not only life-threatening, but also require longer hospital stays and/or hospital readmission. There are no universally accepted VTE screening guidelines for renal transplant recipients (RTRs). The Caprini risk assessment model was the most widely used and validated VTE screening tool in the literature. It was adapted and used in this project’s intervention. In collaboration with The Queen’s Medical Center Transplant Center (QMCTC), an evidence-based quality improvement project was conducted to address the incidence of VTE. The Iowa Model was used framework to guide the process. The purpose of this evidenced-based practice (EBP) project was to implement and evaluate a program that decreased the incidence of venous thromboembolism (VTE) in adult QMCTC patients following renal transplant surgery. Methods The target population was the QMCTC RTRs who underwent surgery. Patients were screened using the QMCTC-adapted Caprini tool prior to surgery. The results from the assessments were then forwarded to the transplant physician team. Methods to assess the program outcomes included monitoring VTE incidence during the implementation period and physician survey. Results During the five-month intervention period, 22 potential candidates for renal transplant were screened, while only 12 underwent surgery. Age and history of major surgery were the only identified risk factors. Zero incidence of VTE was recorded and the overall VTE incidence rate decreased by 0.5%. Discussion The results suggested screening RTRs prior to surgery may decrease the incidence of VTE. Although correlational, the results from the project supported the continued use of the intervention as a cost-saving measure to enhance patient care. Additional implications included raising awareness on VTE and the benefits of EBP projects.