Keywords
NICE NG89 guideline adherence
Quality improvement
Provider education
Clinical audit
How to Cite
Abstract
Background: Venous thromboembolism (VTE) is a major cause of preventable morbidity and mortality in hospitalized patients. Evidence-based guidelines recommend systematic risk assessment and appropriate prophylaxis; however, adherence in routine clinical practice remains inconsistent.
Methods: A prospective, closed-loop clinical audit was conducted in the Department of Medicine at Khyber Teaching Hospital. Adherence to the National Institute for Health and Care Excellence guideline NG89 for VTE prevention was evaluated through a baseline point-prevalence audit of 237 adult medical inpatients. This was followed by a targeted educational intervention consisting of structured teaching sessions for interns and residents. A re-audit of 237 patients using identical inclusion criteria and data collection methods was conducted four weeks after the intervention.
Results: Baseline adherence to NICE NG89 recommendations was 54% (128/237). Following the educational intervention, adherence increased to 89% (211/237), representing an absolute improvement of 35 percentage points.
Conclusion: A focused educational intervention was associated with improved adherence to NICE NG89 VTE prophylaxis recommendations during the re-audit period. These findings suggest that structured educational strategies may improve guideline-based practice in resource-limited settings. However, the short follow-up period and pre–post design without a control group introduced the possibility of Hawthorne and secular effects, and longer-term sustainability was not assessed.
References
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This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2026 Dr. Fahad Naim, MBBS, FCPS, FRCP, Dr. Suleman Khan, MBBS, MD, Dr. Muhammad Saqib, MBBS, MD, Dr. Shabnam Shahjehan, MBBS, Dr. Farwa Aftab, MBBS, Dr. Muhammad Adeel Khan, MBBS, Dr. Nisar Ahmad, MBBS, Dr. Adam Saeed, MBBS, MD, Dr. Khaqan Ahmed, MBBS