815 A Retrospective Audit of the Management of Calcium Following Total or Completion Thyroidectomy, a Two Cycle Audit

Aim Hypocalcaemia is a major complication following total and completion thyroidectomy, causing severe symptoms such as paraesthesia, seizures and increasing hospitalisation time. We aimed to minimise the incidence of complications and readmission due to hypocalcaemia following thyroid surgery by reviewing adherence to local guidelines and considering how current practice could be improved. Method Retrospective analysis of 26 case files was performed, notes were reviewed for documentation of prescription of Calcichew-D3 before surgery, timing of calcium and parathyroid blood tests and whether the local guidelines for post-operative care after total or completion thyroidectomy were correctly followed. A re-audit was performed after local guidelines were updated, an education session was delivered to staff and a pre-operative pack was produced. The pack included the patient’s consent form, symptoms of hypocalcaemia and, if eligible, a prescription of Calcichew-D3. Results 100% of patients had their calcium level correctly checked the following morning. Despite this, 3 patients were readmitted with hypocalcaemia following surgery. There was only evidence that 58% of patients had Calcichew-D3 recommended before surgery. Following the interventions, local guidelines were followed correctly in 100% of patients and no patients were readmitted due to hypocalcaemia over the audit period. Conclusions An update of local guidelines and education of staff led to an increased understanding of the management of hypocalcaemia following thyroid surgery and there was a reduced incidence of readmissions over the audit period. Furthermore, correct use of guidelines would lead to potential cost saving through avoidance of unnecessary blood tests.