612 A Quality Improvement Project of Management of Acute Pancreatitis in a District General Hospital; How Well Are We Doing Against NICE Guidelines?

Abstract Aim Pancreatitis is a common condition with significant complications, and mortality in 5% of cases. We aimed to identify compliance to the National Institute for Health and Care Excellence (NICE) guidelines of pancreatitis management in our District General Hospital (DGH) to improve patient safety and outcomes. Method A retrospective analysis of first-time presentations of acute pancreatitis over a 12-month period, assessing the five domains addressed in NICE-NG104: identifying cause, antibiotic stewardship, nutrition, severity and complications, and lifestyle advice. Our data was compared to that of the PANC study, a UK-national cohort study. Results A total of 33 cases fit criteria –17 male and 16 female. Cause was identified in 55%, of which 86% were within 48 hours. 51% were prescribed antibiotics on admission, of which 23% had an indication recorded. 91% of patients were nil-by-mouth, only 20% of those cases had a reason recorded. Only 6% had severity documented. Four patients were discussed with a tertiary centre. Lifestyle advice was offered to 33% of patients on discharge. In comparison with the PANC Study, there were domains with significant differences. For example, the study reported that 56.4% of cases were offered oral nutrition vs 9% in our DGH, and antibiotics were prescribed in 34% vs 51% locally. Conclusions The audit highlighted need for improvement in NICE guideline compliance of acute pancreatitis management in our DGH. This is being tackled by cycles of quality improvement, including introduction of a ‘Pancreatitis Management Bundle’ and local clinical guidelines, increased staff awareness and patient education.