{
  "abstract": "Background Coronary angiography (CA) is a well-established diagnostic tool with a generally safe profile. However, it is not devoid of major complications such as stroke, myocardial infarction, and vessel embolisation, which significantly contribute to post-procedural morbidity and mortality. Prompt identification of such complications is crucial for early intervention and prevention of clinical deterioration. Currently, there lacks a standardised post-CA assessment pathway.Aims This project aims to enhance the standardisation of documentation and patient assessment post-coronary angiography at Salford Royal Hospital.Methods We conducted two data collection cycles; one prior to and one following the implementation of a newly devised post-angiogram review pathway. Each cycle involved a random selection of patients from the Heart Care Unit at Salford Royal Hospital who underwent CA, spanning a three-month period. The post-intervention cycle was implemented after introducing the pathway, which was made accessible in key Hear Care Unit (HCU) areas and disseminated through email and social media to all doctors. The review documentation included clinical observations, ECG, angiogram findings, A-E assessments, access site examination, peripheral sensation, abdominal examination in femoral approaches, peripheral pulse examination, and capillary refill time (CRT).Results Data were gathered from an average of 43 patients per cycle. Post-intervention, the rate of post-angiogram reviews increased from 72% to 95% ( table 1). The documentation improvements included clinical observations (48% pre vs. 95% post), ECG (61% vs. 80%), angiogram findings (100% vs. 92%), A-E examinations (9% vs. 75%), access site examination (61% vs. 87%), peripheral sensation (24% vs. 72%), and CRT (17% vs. 49%) (table 1). Notably, in the first cycle, all four patients undergoing a femoral approach had documented abdominal exams, and 75% had femoral pulse checks. In the second cycle, documentation occurred in 50% of cases (table 1).Abstract 2-059 Table 1 Pre-intervention cycle (n=46) Post-intervention cycle (n=40) Documented (%) Not documented (%) Documented (%) Not documented (%) Post angiogram review 33 (72%)13 (28%)38 (95%)2 (5%) Clinical observations 22 (48%)24 (52%)32 (80%)8 (20%) ECG findings 28 (61%)18 (39%)36 (90%)4 (10%) Angiogram findings 46 (100%)0 (0%)37 (92%)3 (8%) A-E clinical assessment 4 (9%)42 (91%)30 (75%)10 (25%) Access site examination findings 28 (61%)18 (39%)35 (87%)5 (13%) Peripheral sensory examination 11 (24%)35 (76%)29 (72%)11(28%) Capillary Refill time in radial approach 7 (17%)35 (83%)18 (49%)19 (51%) Abdominal examination findings in femoral approach 4 (100%)0 (0%)1 (50%)1 (50%) Peripheral pulses in femoral approach 3 (75%)1 (25%)1 (50%)1 (50%)Abstract 2-059 Figure 1Conclusion The implementation of the post-angiogram review pathway significantly improved the documentation and standardisation of patient assessments. It highlighted further potential improvements such as accessibility and the practicalities of conducting reviews during busy shifts. Additional PDSA cycles are recommended to continue enhancing this process.",
  "authors": [
    {
      "affiliations": [
        "Northern Care Alliance, Salford Royal Hospital"
      ],
      "name": "Paris Xenofontos"
    },
    {
      "affiliations": [
        "Northern Care Alliance, Salford Royal Hospital"
      ],
      "name": "Firas Elfourtia"
    },
    {
      "affiliations": [
        "Northern Care Alliance, Salford Royal Hospital"
      ],
      "name": "Stephanie Howard"
    },
    {
      "affiliations": [
        "Northern Care Alliance, Salford Royal Hospital"
      ],
      "name": "Lwin Tin"
    }
  ],
  "title": "2-059 Post angiogram review pathway: a quality improvement project",
  "uid": "1334e53e-16fd-5808-a825-7beb2c6890e3"
}