805 An Audit on Managing Acute Pancreatitis in the Adult Critical Care Unit in a DGH

Abstract Aim The aim of the audit is to describe current practice in the management of patients with severe acute pancreatitis admitted to ACCU and to improve quality and consistency of care for this group of patients by developing local clinical guidance on the use of antibiotics and nutritional support. Method A retrospective case note study of the 2-year period between 01/09/2020 to 31/09/2022 at a district general hospital. All adult patient admitted to critical care with acute pancreatitis was included in this study. Results A total of 11 patients were included in our study. 10 patients had antibiotics prescribed during their stay in critical care while one did not as advise by microbiologists. Antibiotic was initiated in 7 cases prior to admission to critical care, with 5 completed the courses of antibiotics which 3 of whom did not have a positive culture or any other sources of infection. With regards to nutrition support, 7 patients were fed via nasogastric tube and 1 with nasojejunal tube. 4 patients were not reviewed by a dietitian during their stay under critical care due to short length of stay over weekend. Conclusions This audit suggests the need for a separate management guideline on managing acute pancreatitis patients in critical care settings. Routine prophylactic antibiotics should be avoided. Regular microbiology rounds would be beneficial in improving quality of care. Early initiation of nutrition on patients in hypercatabolic state is a priority in improving care. Daily dietitian review would enhance the quality and consistency of care.