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Background and Importance Guideline non-adherence regarding anticoagulant prescribing and administration was highlighted in a previous local audit. A re-audit was required to address medication errors and reduce the risk of VTE, haemorrhage, and cerebral accidents.Aim and Objectives Conduct a prospective hospital–wide re–audit on inpatient adult thromboprophylaxis and therapeutic anticoagulation prescribing and administration practicesAssess compliance with local guidelines and quality improvements (QI) from a previous auditDevelop further QI to optimise patient careMaterial and Methods This audit was approved by the local Clinical Audit Committee and conducted over 5 weeks in quarter 4 2024 gathering information from adult inpatient’s drug charts, clinical notes, laboratory results, and communicating with nurses/doctors/pharmacists/patients as required. A Chi-Square test of contingency was used to compare audit results from 2024 and 2022. Generated data were anonymous and securely stored. Independent analysis was conducted by two data collectors to confirm reliability of results.Results 219 inpatients were reviewed comprising 51% on thromboprophylaxis, 30% on therapy, 14% on no anticoagulation, and 5% on anticoagulation on hold. Patient specialty comprised 36% medical, 36% surgical, 18% oncology, and 10% haematology. 29% of inpatients not prescribed anticoagulation required same and 90% of this cohort had no thromboprophylaxis risk assessment complete. All inpatients were appropriately prescribed as per indication. >92% were prescribed at the correct dose, frequency, and time, and in the correct section of the chart. 23% of inpatients on therapy were prescribed antiplatelets, mostly aspirin, appropriately. 33% with therapy on hold were inappropriately held and 50% were prescribed a prophylactic dose in replacement. Statistical significance was observed regarding the correct thromboprophylaxis dose/frequency in comparison to 2022. Reduced dose omissions were identified as well as improvements in thromboprophylaxis prescribed in the correct section of the drug chart and administered at the correct time. With regard to therapeutic anticoagulation, statistical significance was found in the documentation of indications, the absence of dose omissions, and adherence to correct dosing/frequency guidelines.Conclusion and Relevance Results demonstrate an improvement in practice. Continuous education focusing on assessing inpatients on no anticoagulation is ongoing. Local guidelines on perioperative/periprocedural anticoagulation management were updated in July 2025 and have been widely disseminated. An audit re compliance is planned for 2026.Conflict of Interest No conflict of interest