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Bedfordshire Hospitals
NHS Foundation Trust
Paediatric VTE risk assessment Audit 2021
Instructions

Please complete this proforma as fully and comprehensively as you can.  However, when completing this proforma could you please ensure that you do the following things:

1)    Please use https://www.timeanddate.com/date/timeduration.html to calculate the days between two dates for Q1-8 (page 2)
2)    Refer to hospital medical notes, VTE Risk assessment tool, medchart, discharge letter (for last ward) etc.
Is the VTE risk assessment found in the medical notes?
Yes
No
Is the VTE risk assessment not completed?
Yes
No
Is the VTE risk assessment partially completed?
Yes
No
Gender
Male
Female
Hospital Number
Age
Ward
Meadowbank
Riverbank
Ward 24 - Squirrel
Ward 25 - Rabbit
Ward 26 - Hedgehog
Ward 26 HDU
Other
Please Specify ward if Other is ticked
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