295 Secondary Prevention of Cardiovascular Risk Factors in Patients Admitted Under the Vascular Service - Full Cycle Audit

Abstract

Abstract Aim Peripheral arterial disease (PAD) is strongly associated with general cardiovascular morbidity and mortality. This audit aimed to monitor and improve compliance with NICE guidelines CG147 & TA607 for PAD patients that presented to our vascular service. Method Patients were audited from September to October 2020. The audit reviewed prescription of anticoagulant/antiplatelet agents, lipid modification, optimisation of diabetes control and smoking cessation advice. Our intervention was to conduct a single teaching session for junior doctors that emphasised medication checks, checking HBA1c/ensuring appropriate diabetic referrals, and implementation/documentation of any smoking cessation advice. We also introduced a dedicated computer for conducting the vascular surgery morning ward round. Re-audit was undertaken between November to December 2020. Results The first audit included 32 patients. It revealed 100% compliance with anticoagulant/antiplatelet prescribing. 82% were prescribed appropriate lipid modification. There was 75% compliance with diabetic referrals for patients with high HBA1c results. There was only 19% compliance with smoking cessation advice/documentation. The re-audit process included 27 patients. There was 100% compliance with antiplatelet/anticoagulant prescriptions. 26 (96%) patients were prescribed appropriate lipid modification. There was now 100% compliance with appropriate referral to the diabetic team. There was also 100% compliance with smoking cessation advice/assistance/documentation. Conclusions A single teaching session for junior doctors familiarising them with the current national guidelines, and introduction of a dedicated computer for ward rounds significantly helped improve our compliance with national guidelines for secondary prevention of vascular disease.