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• W3213184295 abstract "<h3>Introduction</h3> Variceal bleeding in liver disease is associated with significant mortality and morbidity. Early recognition and appropriate interventions are crucial in managing patients with acute variceal bleeding. <h3>Methods</h3> Patients presented with acute variceal haemorrhage to Prince Charles Hospital and Royal Glamorgan Hospital were retrospectively identified using our endoscopy database. Four locally agreed key performance factors including early endoscopy within 24 hours, use of prophylactic antibiotics, documentation of Glasgow Blatchford Score (GBS) and correct identification of upper gastrointestinal bleed (UGIB) on initial presentation were assessed in patients presented between February 2018 to February 2019 in the initial audit cycle.These factors were audited again for patients from March 2019 to December 2019, after the introduction of SBAR proforma and out-of-hours (OOH) GI bleed on call rota. <h3>Results</h3> A total of 31 patients were included in initial audit and 13 patients in the reaudit.In the first audit it showed that compliance with endoscopy within 24 hours was 96%, prophylactic antibiotics was 74%, GBS documentation was 55% and identification of upper GI Bleed on admission was 100%. After the introduction of UGI bleed SBAR proforma and OOH GI bleed on call rota, the repeat audit of the same factors showed improvement in GBS documentation to 92% and prophylactic antibiotics use on admission to 85% while UGIB identification on admission remained 100%. Endoscopy within 24 hrs of admission was 85%, but this was due to the risk benefit review of a case and the need for urgent endoscopy by the team.Endoscopic procedures done OOH initially was 22% which rose to 31% after introduction of UGI bleed on call service. Additional information also showed that SBAR proforma was used in 62% of cases. It also showed better use of the in hours endoscopy services, as more cases were discussed appropriately with the on call Gastroenterologists. <h3>Conclusion</h3> This audit concludes that there was better documentation of GBS, use of prophylactic antibiotics, appropriate early recognition and management of variceal bleeding by using available endoscopy service and the appropriate use of on call service for these patients, who generally have significant morbidity due to their underlying liver disease.We recommended that repeating the audit cycle in 12-24 months would be valuable to see whether these improvements are sustained and to reassess the long term benefit of GI bleed on call service in effectively managing these patients. We also suggest that we should aim to achieve 100% compliance in these performance factors along with appropriate management of associated liver disease." @default.
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• W3213184295 date "2021-11-01" @default.
• W3213184295 modified "2023-09-26" @default.
• W3213184295 title "PTH-19 Assessing the impact of SBAR proforma and GI bleed rota in managing variceal bleed patients" @default.
• W3213184295 doi "https://doi.org/10.1136/gutjnl-2021-bsg.334" @default.
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