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• W2912681189 abstract "Introduction: Spontaneous bacterial peritonitis (SBP) is a serious, potentially life-threatening complication of liver disease that requires abdominal paracentesis for diagnosis and treatment. Decreasing morbidity/mortality in patients with SBP is something hospitals are striving to improve. Recent studies have shown that delayed paracentesis (done 12-72 hours after hospitalization) is associated with higher mortality, longer hospital stay, and higher ICU days vs. early paracentesis (done within 12 hours of hospitalization). Since delayed paracentesis is associated with a 2.7-fold increased risk of mortality, paracentesis performed < 12 h from hospitalization may improve short-term survival. This quality improvement project looks at current time to paracentesis in patients admitted to Truman Medical Center (TMC) with ascites with the goal of improving the % of paracentesis performed within the first 12 hours of hospitalization. Methods: Our QI study was a retrospective analysis looking at patients admitted to TMC in 2015 who underwent paracentesis (had ascitic fluid analysis in EMR). N=137. Timeframe starts with first physician encounter (start time of ED provider note) and ends when results from cell count are available. Only first diagnostic paracentesis considered (multiple patients received >1 during admission). We assessed preintervention data, performed interventions, and assessed post-intervention data. Results: Of the 137 patients who underwent paracentesis in 2015, 26 (19%) were done within the goal of the first 12 hours, while 111 (81%) were performed after 12 hours. independent T-test showed no statistically significant difference in day vs night admissions with a p-value of 0.255. Interventions were implemented, including IM resident education (PowerPoint presentation during IM conference), and a paracentesis skills lab. Post-intervention data for the month of March 2016 was assessed and 11 paracentesis were performed. Of these, 4 occurred within the first 12 hours (36%), 3 (27%) were performed within 12-24 hours, while 4 (36%) occurred after 24 hours.Figure 1Figure 2Figure 3Conclusion: Despite low patient numbers given our short post-intervention collection time frame, there was an improvement in the percentage of patients who underwent paracentesis within the first 12 hours of hospitalization (19% pre-intervention vs 36% post-intervention). This is an important and encouraging breakthrough and continued work on this project will show higher data numbers and improved percentages in the future." @default.
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• W2912681189 date "2016-10-01" @default.
• W2912681189 modified "2023-09-24" @default.
• W2912681189 title "Decreasing Time to Paracentesis in Patients Admitted with Ascites" @default.
• W2912681189 doi "https://doi.org/10.14309/00000434-201610001-00833" @default.
• W2912681189 hasPublicationYear "2016" @default.
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