An audit of anticoagulant guidelines: the relative influence of education, presentation and complexity of guidelines on compliance

Abstract

Because of a high incidence of bleeding complications, guidelines for the use of anticoagulants were introduced in our two acute district hospitals and audited on three occasions. Changes were made to the educational input, presentation of the guidelines and the guidelines themselves, between the audits, thus allowing evaluation of these possible influencing factors. Even with an intensive and continuing education programme, the work sheets (proforma) developed for the guidelines were used in only 41% of patients. When used, compliance with the guidelines was good and better than when the proformas were not used. Changing the way the guidelines were presented and the format of the proforma did not materially influence compliance, nor did the educational input, but simplifying the guidelines, by using low molecular weight heparin for deep venous thrombosis, led to considerable improvement. The complexity of guidelines should be a primary consideration when they are drawn up.

Citation

Bradley, G. (1998), "An audit of anticoagulant guidelines: the relative influence of education, presentation and complexity of guidelines on compliance", Journal of Clinical Effectiveness, Vol. 3 No. 2, pp. 84-89. https://doi.org/10.1108/eb020881