AB121. SOH23ABS_064. Clinical audit of sedation use and comfort scores for colonoscopy at Midlands Regional Hospital Tullamore (MRHT)
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AB121. SOH23ABS_064. Clinical audit of sedation use and comfort scores for colonoscopy at Midlands Regional Hospital Tullamore (MRHT)

Danica Jekic, Nicola Raftery, Tarig Abdelhafiz, Abubakr Rayis, Sean Johnston

Department of General Surgery, Midlands Regional Hospital Tullamore, Tullamore, Ireland

Background: The Joint Advisory Group on GI Endoscopy (JAG) and British Society of Gastroenterology (BSG) established a set of Key Performance Indicators (KPIs) as targets to achieve the highest quality of care and safety for patients undergoing colonoscopy. Sedation KPIs recommend in patients <70 a mean Fentanyl use of <100 mcg and <5 mg of Midazolam whilst in patients >70 a mean dose of <50 mcg Fentanyl and <2 mg Midazolam is recommended. Ideally <10% of patients would have moderate to severe discomfort (Gloucester scale 4–5). All endoscopy units should consider these KPIs a benchmark on which to audit their practice to ensure optimum quality and safety for their patients.

Methods: A clinical audit of consecutive colonoscopy reports of surgical patients at MRHT from August-November 2022 was performed. A report was generated using EndoRad software. Information regarding the dosages of sedation and comfort scores was compiled. Plans to re-audit in early 2023 are in place.

Results: A total of 332 consecutive patient’s colonoscopies were assessed. Patients <70 received a median dosage of 4 mg of midazolam (n=247), 75 mg of fentanyl (n=243). Patients >70 received a median dosage of 4 mg of midazolam (n=82), 50 mg of fentanyl (n=79). The median overall comfort score was 2 (n=332), and 14% of patients scored 4–5 on the Gloucester scale.

Conclusions: Patients <70 adhered adequately to KPIs. Our unit used higher doses than recommended of Fentanyl in the >70 cohort. Through education seminars on KPIs within our endoscopy unit, we aim to target this and aim to re-audit in early 2023 to ensure KPIs are being adhered to.

Keywords: Colonoscopy; comfort score; fentanyl; key performance indicator; midazolam

Acknowledgments

Funding: None.

Footnote

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-23-ab121
Cite this abstract as: Jekic D, Raftery N, Abdelhafiz T, Rayis A, Johnston S. AB121. SOH23ABS_064. Clinical audit of sedation use and comfort scores for colonoscopy at Midlands Regional Hospital Tullamore (MRHT). Mesentery Peritoneum 2023;7:AB121.

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