478 Improving the Prescription of Key Medications for Inpatients Admitted to the Royal Cornwall Hospital with an Acute Sore Throat: A Quality-Improvement Project

Introduction The regular administration of intravenous antibiotics, analgesia, steroids, and adequate venous thromboembolism (VTE) prophylaxis is important when managing patients with an acute sore throat. Therefore, a quality-improvement project, aiming to improve the prescription of these medications within the Royal Cornwall Hospital (RCHT) Ear Nose and Throat (ENT) department, was undertaken to enhance patient recovery and reduce length of stay (LOS). Method Electronic drug charts of adult patients admitted under ENT with an acute sore throat from March to May 2023 were consulted. Information on whether patients had been prescribed regular analgesia, antibiotics, steroids (if indicated), adequate VTE prophylaxis and their LOS was sought. Results A total of 58 patients were included. The majority (59%) were male, and the mean age was 29. The most common diagnoses were Tonsillitis (43%), followed by Quinsy (30%) and Supraglottitis (10%). The mean LOS was 1.2 days. Regular analgesia was prescribed for 52% of patients on admission, and 78% during their inpatient stay. Regular antibiotics were prescribed for 73% of patients on admission, and all patients during their inpatient stay. Regular steroids were only prescribed to 42% of patients that needed them, and 69% of patients were prescribed VTE prophylaxis. Conclusions These findings indicate a need to improve the prescription of regular analgesia, antibiotics on admission, VTE prophylaxis and steroids if indicated. An Acute ENT Sore Throat electronic prescribing protocol has subsequently been developed and disseminated amongst RCHT junior doctors. A second cycle of data-collection will be undertaken to examine the subsequent effects on patient care and LOS.