EP 292 Improving Adherence to Pre-Operative Assessment Investigation Guidelines for Elective Breast Surgery: A Clinical Audit
Hafsah Ba, Camilla Knight, Elizabeth Senyo, Chien Soh, Ken Ho, Hirah RizkiAbstract
Aims
The project aims to improve completion of required pre-operative assessment (POA) investigations for elective breast surgery patients according to local and national guidance, reducing the need for repeat hospital visits.
Methods
A retrospective data collection was conducted for patients undergoing elective breast surgery with POA appointments between November-December 2025 in a tertiary breast surgery unit. Emergency and joint-plastic surgery cases were excluded. Data was collected from electronic patient records (EPR) including demographics, procedures, and investigations such as full blood count (FBC), urea and electrolytes (U&Es), clotting screen, group and save (G&S), ECG, haemoglobin A1c (HbA1c) and MRSA swabs. Compliance for POA investigations was assessed against NICE guidelines (NG45) and time between POA, and surgery were assessed against trust guidance (at least two weeks prior to surgery).
Results
70 adult patients were included in the study. On average, patients had their POA 12.8 days before their procedure. The highest compliance was FBC at 100% (70/70) and MRSA swabs at 98.6% (69/70). The lowest compliance was clotting screen at 62.6% (42/67) and G&S at 69.1% (47/68). Compliance for renal function was at 95.6% (65/68), HbA1c at 84.6% (11/13) and ECG at 90.9% (40/44).
Conclusion
The audit identified good compliance with investigations aside from clotting screen and G&S due to ambiguity in guidelines. Missed investigations may result in delayed surgeries. The proposed interventions will include multidisciplinary team discussions, an EPR virtual checklist and staff education sessions. A re-audit will be planned in 3 months to assess improvement post-intervention.