ABSTRACT #53

ASSESSMENT OF POST-PROCEDURAL COMPLICATIONS IN THE INPATIENT SETTING: IMPLEMENTATION OF A STANDARDIZED COMPREHENSIVE DOCUMENTATION TOOL

Kristine Lou Gargaritano, Irina Zaretsky, Shantheri Shenoy

PURPOSE AND GOALS: Bedside procedures such as paracentesis, lumbar puncture, and thoracentesis are commonly performed on the general medicine wards by house staff, advanced practice providers, and attending physicians. While such procedures are considered safe and cost effective, lack of prompt detection of serious complications can have life threatening implications. We aim to promote patient safety in the post procedural period by performing timely and comprehensive assessment of patients through a standardized approach. Our goal is to improve provider compliance with evaluation of patients at 4 to 6 hours post procedures. We plan to analyze the post procedure complication detection rate and the effects of medical interventions implemented on patient outcomes.

METHODS: Our team designed a standardized template note within our electronic medical record (EMR) system to guide comprehensive post procedure patient assessments. The template is available to all providers within the department of medicine. The template prompts providers to document the following: time of assessment, procedure- related symptoms, a detailed physical examination, relevant labs and imaging, any post-procedural complications, a follow-up plan, and confirmation of the plan of care communication with nursing staff as well as the patient or the patient’s health care proxy. Educational sessions are currently being conducted within the department of medicine to promote provider awareness and compliance with the utilization of our template.

EVALUATION PLAN: Patient charts will be reviewed following educational interventions to assess for compliance with the post procedure template completion. We will perform additional didactics if needed depending on our results. We will then assess the types of complications identified and assess the impact of early detection on patient outcomes.

SUMMARY OF RESULTS: Data collection will begin after the completion of educational interventions.

REFLECTIVE CRITIQUE: We hypothesize that systematic post-procedure patient evaluations will allow for early detection of complications, prompt intervention, and improvement in patient safety and outcomes