{
  "abstract": "Background Hepatic encephalopathy (HE) is a frequent, potentially life-threatening complication of cirrhosis. Early recognition is often delayed due to subtle cognitive and neurological changes. This Quality Improvement Project (QIP) aimed to implement structured nursing checklists to enhance early detection and timely intervention for HE.Methods A six-month prospective QIP included 120 adult inpatients with cirrhosis at a tertiary hospital in Kashmir. Daily nursing checklists assessed mental status, orientation, sleep patterns, and early neurological signs. Checklist compliance, time to intervention, incidence of severe HE, and hospital stay were compared to baseline data.Results Checklist compliance reached 92%. Early recognition improved from 45% to 88%, reducing median time to intervention from 12 hours to 4 hours. Severe HE episodes decreased from 22% to 10%, and the average hospital stay shortened by 2 days. Nursing staff reported improved confidence in detecting early HE signs.Conclusions Structured nursing checklists are a simple, cost-effective intervention that improves early HE detection, reduces complications, and shortens hospitalization. Standardized implementation can enhance patient safety and clinical outcomes in cirrhosis care.",
  "authors": [
    {
      "affiliations": [
        "Rawal Institute of Health Sciences, Islamabad, Pakistan"
      ],
      "name": "Usman Ghani"
    }
  ],
  "title": "IDDF2026-ABS-0450 Quality improvement project: enhancing early detection of hepatic encephalopathy using structured nursing checklists",
  "uid": "ad34b511-86e9-5101-98c5-c923ec3c1f04"
}