Implementing Wells' criteria to improve deep vein thrombosis screening in housebound patients.

Background: Screening of deep vein thrombosis (DVT) is an NHS priority for improving community health service. Effective DVT screening and documentation improve patient outcomes, prevent prolonged hospitalisation and lead to fewer expenses. The lack of evidence of DVT screening in the community requires action. This Quality Improvement Project focuses on improving DVT screening and documentation for housebound patients in the community.

Aim: To improve screening and documentation of DVT in four months by introducing several interventions in collaboration with one care community.

Methods: The authors used a fishbone analysis and driver diagram to form three 'Plan, Do, Study and Act' cycles. The authors also developed a Wells' template, delivered a training session, had a team meeting with community nurses, audited their screening records and collected their feedback.

Findings: There was a 74% increase in staff using the National Institute for Health and Care Excellence guidelines and 100% documentation of DVT assessment, of which 82% used the Wells' score template.

Conclusions: DVT screening and documentation in community services can be optimised and sustained with training and monitoring.