EP 570 Auditing Elective Admission in Vascular Surgery

Aim To evaluate perioperative antiplatelet and anticoagulant prescription and administration in elective vascular admissions, identifying predictors of deviation from best practice in accordance with ESVS guidelines. Method A retrospective audit was conducted in a tertiary vascular centre focusing on elective admissions scheduled between 24/11 - 02/01/26 (completed operations/discharged patients). Procedures were coded 1-4 (Interventional Radiology (IR), Open, Endovascular, Hybrid). Data was extracted from hospital electronic patient records including: presence of clerking note, clinically appropriate prescription, and compliance to standard at end outcome. Predictors: admission ward, pre-admission medication regimen, prescribed regimen, evidence of senior advice, root cause error (prescriber vs administrator). Prescribing appropriacy was benchmarked against ESVS guidelines and appraised by a Senior Consultant Vascular Surgeon. Results Total of 26 patient notes were audited. Streams: 1-IR (50%), 2-Open (26.9%), 3-EVAR (15.4%), 4-Hybrid (7.7%). Overall clinical standards were met only in 50% (n=13). Non-compliance was highest in IR procedures (53.84% error). Root prescriber error accounted for 84.6% (n=11) of cases where standard was not met, with Single Antiplatelet omissions accounting for 30.8%. Administrator error accounted for 15.4%. Interestingly, designated vascular ward error (55.5%) and outlier wards (50%) were comparable. The strongest predictor of ESVS compliance was linked to evidence of senior review (60%). Conclusions There is strong evidence for intervention in prescribing/clerking process, mandated senior overview, and minimising inappropriate medication omission. Limitations included overlap of clerking doctors and auditing members and data being within an industrial strike action period. Potential future interventions to evaluate include clerking proformas and prescriber education.