701 Resuscitation and Escalation Status Documentation in Acute Surgical Admissions: A Re-Audit Feb 2020

Abstract

Abstract Aim Resuscitation and escalation of care are not always in the best interests of all patients. Planning ahead for patient’s escalation and CPR status, along with clear documentation can prevent inappropriate cardiac arrest calls. Previous audits on CPR and escalation status were conducted in 2017, 18 and 19 and the completion of CPR and escalation documentation was 0, 2 and 12% prospectively, with an improvement to 42% after an intervention in the 2019 audit. A re-audit for 2020 is conducted. Method A snapshot audit of patients who were admitted or referred to General Surgery between 10-17 Feb 20 were identified, admission record and medical notes reviewed. CPR and escalation status, presence of a DNACPR form, record of discussion with the patient or their family and the medical notes entry were reviewed. Results 46.6% (34/73) of admissions had CPR and escalation status completed. Out of the admissions, all patients who were deemed not for resuscitation had DNACPR forms in their admission notes. All of these were discussed with either the patient or with their family, and the decisions appropriately documented in their medical notes. Conclusions This re-audit had shown improvement in the documentation on escalation and CPR status. This area can be improved further. Our recommendations include: 1. To present this finding in the education meeting and 2. Junior doctors to highlight the documentation to the oncall consultant/ or registrar during the first senior review and 3. To conduct a questionnaire to explore the surgeons’ views on this subject.