Clinical Audit of Venous Thromboembolism (VTE) Risk Assessment and Guideline Compliance in Surgical Practice.

Background Venous thromboembolism (VTE) remains a major cause of preventable morbidity and mortality among surgical inpatients. Despite established international guidelines, adherence to prophylaxis protocols is often suboptimal in clinical practice. Objective To evaluate and improve adherence to VTE risk assessment and prophylaxis guidelines among surgical patients at Port Sudan Doctors Hospital through a structured clinical audit. Methods A two-cycle prospective clinical audit was conducted. The first cycle (September 2024) involved a retrospective review of 50 surgical inpatient records and a gap analysis through staff interviews and observations. A two-month intervention followed, introducing a standardized VTE risk assessment tool, staff training, and integration of clinical workflows. The second cycle (January-April 2025) included a prospective review of 41 patient records and qualitative staff feedback. Data were analyzed descriptively and thematically. Results Compliance with VTE prophylaxis guidelines improved significantly from 6% in the first cycle to 85.4% in the second. Patient education increased from 4% to 95.1%, and proper documentation of prophylaxis duration improved from 6% to 95.1%. The use of structured risk assessment tools (e.g., Caprini score) increased from 7.1% to 50%, while inappropriate pharmacological prophylaxis for low-risk patients was eliminated. Staff engagement and usability of tools were also enhanced. Conclusion Targeted interventions, including standardized risk assessment and focused staff education, significantly improved VTE prophylaxis practices. Sustained improvements will require continued auditing, digital integration of tools, and institutional support to promote long-term adherence and patient safety.