765 Improving the Assessment of Patients Post-Angioplasty: A Quality Improvement Project in a District General Hospital

Abstract

Abstract Aim Complications post-angioplasty are rare and include haematomas, haemorrhage, and acute limb ischaemia. National guidelines recommend patients should be kept in an area where limb perfusion and complications can be assessed, but doesn’t detail what this encompasses. Others have suggested this could include examination of pulses, limb perfusion and an ankle brachial pressure index (ABPI). This QIP aimed to improve the examination of patients’ post-angioplasty and develop internal guidelines to support this. Method Data was collected retrospectively between 01/12/2021 – 18/03/2022 and 25/03/2022 – 31/07/2022 for patients undergoing inpatient angioplasties. Documentation was examined for evidence of assessment of the following domains: 1) Peripheral pulses, 2) Wound site, 3) Haemodynamic stability, 4) Limb perfusion, 5) ABPI, 6) Decision regarding anticoagulation, and 7) Same day assessment. A teaching session was delivered to doctors teaching them how to examine these patients, use a doppler and measure an ABPI. We re-audited and created guidelines which were displayed on the surgical wards. Results There was a notable improvement in the examination of peripheral pulses (33% to 100%), wound sites (47% to 93%), limb perfusion (40% to 93%), same day review (73% to 86%) and decisions regarding anticoagulation (60% to 71%). Haemodynamic stability and ABPI remained unchanged. Conclusions We show that teaching juniors how to examine patients’ post-angioplasty improves the assessment of these patients. This is important for early identification and treatment of complications. Though this was carried out in a small district general hospital, it also highlights the need for more detailed national guidance.