WTP2.02 GIRFT in Pediatric Acute Appendicitis

Aims This study aims to evaluate the current practice in managing pediatric appendicitis at our institution and benchmark it against the GIRFT (Getting It Right The First Time) guidelines for best practice. The focus is on the following areas: pain control, antibiotic management, imaginings, negative appendicectomies rates (NAR) and outcomes in order to enhance patient experiences. Methods A retrospective audit was conducted from May 1 to October 31, 2022. All patients under 18 years old who underwent appendicectomy or diagnostic laparoscopy for abdominal pain were included. Data collected included demographics, pain management, diagnostic pathways, surgical timing, antibiotic strategies, and postoperative outcomes. Results A total of 27 patients were included (median age: 14 years; 70% male). Key findings revealed that only 44% of patients had their pain scored at triage, with an average delay of 2 hours and 34 minutes to receive analgesia. Diagnostic pathways were inconsistent; no clinical scores were documented, and the median time from diagnosis to surgery was 23 hours, exceeding the 24-hour benchmark in several cases. The negative appendicectomy rate was 22%, significantly higher than the GIRFT recommendation of ≤2.5%. Complication rates included intra-abdominal abscesses (15%) and one wound infection. Antibiotic use lacked consistency, and no information leaflets were provided to patients and families at discharge. Conclusion Current practices fall short of GIRFT guidelines in several area: pain management, diagnostic consistency, and surgical timing. Introducing structured care pathways, enhanced analgesia protocols, antibiotic guidelines and patient education materials is essential to improve outcomes and align with best practices.