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- W4381125747 abstract "<h3>Introduction</h3> The British Society of Gastroenterology (BSG) Upper GI Bleeding (UGIB) care bundle was created to offer clinicians effective, ward based interventions in order to improve standards of care for this common medical emergency. We aimed to assess the impact of the UGIB bundle on key quality standards and pre-defined patient outcomes, following its implementation in 2018. <h3>Methods</h3> Using a retrospective analysis of prospectively collected data, we analysed consecutive patients presenting to Glasgow Royal Infirmary with UGIB over three separate six-week time periods – in the Autumn of 2018, 2020 and 2022. These data included: rates of bundle use, medical management and interventions, as well as patient outcomes including length of stay, rebleeding rates and 30-day mortality. Comparisons were made and trends identified between these time periods. <h3>Results</h3> Overall, 131 patients were included in the study (2018 n=45; 2020 n=44; 2022 n=42). Rates of bundle use dropped from 87% (2018) to 23% (2020) (p<0.001) and were similar thereafter; 26% (2022). Documentation rates of Glasgow Blatchford Score (GBS) peaked at 82% (2020) but subsequently fell to 48% (2022) (p=0.049). Appropriate use of proton pump inhibitors, antibiotics and terlipressin were consistent throughout. Endoscopy was performed within 24h in 78% of cases in 2018, 82% in 2020 and 79% in 2022 (p=NS). Mean length of stay (days) was unchanged between 2018 -2020 (11 vs 8.5, p=0.3) however increased in 2022 (13.8, p=0.048). 7-day rebleeding rates were unchanged 4% (2018), 0% (2020), 0% (2022) (p=0.15). Differences in 30-day mortality rates over the study period were not statistically significant: 0% (2018), 4.5% (2020) and 7.1% (2022) (p=0.12). <h3>Conclusion</h3> Use of the UGIB bundle has fallen since its initial conception and appears to correlate with reduced GBS documentation and increased length of hospital stay. Mortality rates have not significantly changed. Ongoing education of clinicians involved in managing UGIB, including the use of the UGIB bundle, may improve patient management and outcomes." @default.
- W4381125747 created "2023-06-19" @default.
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- W4381125747 date "2023-06-01" @default.
- W4381125747 modified "2023-09-27" @default.
- W4381125747 title "O41 Embedding quality improvement in Upper GI Bleeding using a clinical care bundle: a four year analysis" @default.
- W4381125747 doi "https://doi.org/10.1136/gutjnl-2023-bsg.40" @default.
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