Aim:
To evaluate the impact of interventions implemented after an initial audit and to compare compliance with the recommended timing of enoxaparin administration for VTE prophylaxis following caesarean section.
Methods:
An initial retrospective audit at The Northern Hospital in November 2024 reviewed 115 post-caesarean patients. Following identification of a need to improve compliance, the electronic VTE risk assessment tool was revised to improve accessibility and usability, and targeted education was provided. After allowing time for implementation, a follow-up audit was conducted in February 2026, reviewing 106 patients. Timing of the first enoxaparin dose was compared with local and international recommendations.
Results:
In 2024, 96/115 (83.5%) patients received enoxaparin. Of these, 9 (9.4%) received it within the recommended 5–7-hour window, 1 (1.0%) within 4 hours, 34 (35.4%) at 7–10 hours, 42 (42.7%) at 10–24 hours, and 11 (11.5%) after 24 hours. In 2026, 82/106 (77.4%) received enoxaparin. No patients received it within 4 hours. Administration within the recommended 5–7-hour window increased to 10/82 (12.1%), while 30 (36.5%) received it at 7–10 hours, 35 (42.6%) at 10–24 hours, and 7 (8.5%) after 24 hours. None of these results showed a statistically significant difference.
Conclusions:
Following the interventions and targeted education, no patients received enoxaparin within 4 hours, while administration within the recommended 5–7-hour window modestly improved from 9.4% to 12.1%. However, delayed administration remained common, highlighting the need for continued education and monitoring to improve compliance.