841 The Management of Post-Operative Haemorrhage in Thyroid and Parathyroid Surgery: An Educational Quality Improvement Project in ENT

Aim To improve understanding of the protocol and critical urgency of post-operative haemorrhage and actions needed to secure a safe airway in patients’ post-thyroid and parathyroid surgery, in the ENT department of Castle Hill Hospital. Method Employing the guidelines established by The British Association of Endocrine & Thyroid Surgeons (BAETS), we devised identical questionnaires to be completed before and after the intervention on google forms. The intervention was a delivered as a video on acute haemorrhage management and one-to-one teaching. In November 2023, the survey was circulated to all ward and theatre staff responsible for the care of these patients. The pre- and post-intervention questionnaire included qualitative and quantitative questions, measuring competence in identifying and managing post-operative haemorrhage. Statistical analysis involved a paired t-test to evaluate differences in pre- and post-intervention data. Results 19 responses were collected, yielding an 83% follow up rate. On a Likert-scale of 1-10, the confidence of managing a post-operative haemorrhage increased from 5.05 to 6.63, showing a significant increase (p>0.0015). Similarly, the overall score of the questionnaire increased from 6.68 to 8.68, showing a significant increase (p<0.0001). Qualitative feedback indicated the need for formal departmental teaching in the management of a post-operative haemorrhage. Conclusions Staff interacting with patients following thyroid surgery should be trained to recognise and manage a haemorrhage. There is no formal inclusion of acute haemorrhage management in the departmental induction for staff, which should be added in subsequent rotation inductions. Simulation exercises will be trialled to improve retention in subsequent cycles of this quality improvement project.