Nuliyati Businje

1. 1. risk assessment tool suggests no further assessment needed

   “Despite evidence to suggest that mobility is not the ultimate deciding factor of risk of DVT, the risk assessment tool as currently drafted and relied upon by clinicians would suggest that there is no further need for assessment. This raises a risk of future deaths for those patients such as Ms [name redacted] who were at risk of VTE, or those with cancer for example, but who do not have significnstly reduced mobility and would therefore fall outside of the risk assessment.”

2. 2. risk assessment omits psychiatric DVT risk

   “Based on the evidence I heard, patients on a psychiatric unit are at increased risk of DVT but this is not factored into the risk assessment, nor the NICE guidance. The latter guidance has a specific section for psychiatric patients but does not provide any specific information as to risk and directs the reader to the same Department of Health risk assessment tool.”

3. 3. clinicians miss clot signs due to unawareness of observation normalisation

   “Based on the evidence of the expert physician, a common presentation of a clot can be a derangement in observations such as respiratory rate and heart rate, but these can normalise as the clot passes further on and the blockage eases. I am concerned that this does not appear to be widely known, is not part of training at least in the Trust in this case due to the lack of awareness, and I am told is not something which is taught nationally. There is a risk that a clinician without this knowledge”

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