465 Ensuring Optimal Timing of Gastrografin and Imaging in Patients with Adhesive Small Bowel Obstruction

Abstract

Abstract Aim This Quality Improvement Project (QIP) aimed to optimise outcomes for patients with adhesive small bowel obstruction (aSBO) by standardising Gastrografin prescriptions and the timing of subsequent abdominal X-rays (AXRs). Method Baseline data on Gastrografin prescription and timing of AXR for patients with aSBO was collected retrospectively over a 1-year period. From this, we identified potential interventions to reduce variation in the management of aSBO. We implemented a Plan-Do-Study-Act (PDSA) Cycle over a 4-month period by creating a prescribing protocol for Gastrografin on the Trust's electronic prescribing system with input from key stakeholders including surgeons, pharmacists, radiologists, and radiographers. We measured Gastrografin prescription accuracy and timing of AXR post-Gastrografin. Results The initial data collection (n=89) showed Gastrografin was used in 63% of SBO episodes and prescribed correctly in 79% of cases. AXR was performed in 77% of cases, with a mean time of 9:02 hours post-Gastrografin administration. 42% of patients underwent surgery. After implementation of our PDSA cycle (n=20), Gastrografin was prescribed in 71% of cases, with 100% prescription accuracy. AXR was performed in 88% of cases, with a mean time of 7:47 hours post-Gastrografin. 10% of patients underwent surgery. Conclusions We have successfully achieved our aim of reducing variation in Gastrografin prescription for patients with aSBO by demonstrating an increase in prescription accuracy from 79% to 100%. We have also shown an improvement in the efficiency of post-Gastrografin imaging for patients with aSBO.