84 Optimising The Assessment and Management of Acute Renal Colic in Secondary Care

Abstract

Abstract Aim The latest guidance in acute renal colic states that patients should have serum calcium and urate (stone bloods) measured during inpatient admission. The guidance also states that follow-up imaging should be in the form of computed tomography (CT)-, ultrasound (USS)-, or X-ray- kidney, ureters and bladder (KUB). X-ray intravenous urogram (IVU) is now considered obsolete as it can result in over-exposing patients to radiation. Aims of this 2-cycle QIP were twofold; Method Data was extracted from electronic patient records on whether or not they had stone bloods measured during admission and also what follow-up imaging was requested. In the first cycle baseline data was extracted. A stone proforma was then created, incorporating the latest guidelines. In the second cycle the impact of the stone proforma was assessed. Results The study included 119 patients. After introducing the stone proforma we were successful in improving the rate of stone bloods being measured, increasing from 13% to 53%. We were also successful in reducing the rate of performing X-ray IVU, decreasing from 25% to 14% of patients. Conclusions This QIP demonstrates that management of acute renal colic can be optimised using a stone proforma and move current practice towards best practice. This is supported by the ‘Getting it Right First Time’ (GIRFT) Urology report 2018. The third cycle is currently underway, and we hope to see further improved outcomes.