EP 547 Fluid Administration in Surgical Patients at Risk of Nephrotoxicity Requiring a Contrast CT Scan

Abstract

This project aimed to assess the compliance of the busy general surgical department at our district general hospital to Royal College of Radiologists guidance regarding fluid prescription and administration prior to CT – AP with contrast in patients at risk of nephrotoxicity. Guidance suggests that prior to CT scans, these patients should receive Sodium chloride 0.9% 1L over a minimum of 6 hours prior to administration of the contrast medium. However, on review of inpatient data over a 2-month period, only 0.083% of patients received 6 hours of fluid prior to their scan. This can lead to an increased risk of development of AKI, putting the patient at risk. This study implemented a series of plan-do-study-act (PDSA) cycles to address the problem at hand with the aim to improve compliance with guidelines. The first cycle involved creation of a poster detailing the fluid administration guidance for circulation within the department. This was followed by a presentation to the department regarding appropriate fluid administration to further raise awareness. Following each cycle, adherence to the protocol was assessed via data collection. The project resulted in an improvement within the department of fluid prescription prior to contrast CT scans. This demonstrates the importance of audit PDSA cycles in assessing and implementing adherence to guidelines to improve patient safety.