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Improving documentation of anticoagulation and antiplatelet recommendations after outpatient endoscopy

Clear documentation of instructions for resuming anticoagulant and antiplatelet (AC/AP) medications after gastrointestinal endoscopy is essential for high-quality postprocedure care. Yet, these recommendations are frequently absent, which may impact patient safety. We aimed to improve documentation...

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Autores principales: O'Connell, Brendon, Boyd, Amanda, Kothari, Darshan, Miller, Neena, Cornejo, Jennifer, Sullivan, Brian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9723851/
https://www.ncbi.nlm.nih.gov/pubmed/36588305
http://dx.doi.org/10.1136/bmjoq-2021-001725
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author O'Connell, Brendon
Boyd, Amanda
Kothari, Darshan
Miller, Neena
Cornejo, Jennifer
Sullivan, Brian
author_facet O'Connell, Brendon
Boyd, Amanda
Kothari, Darshan
Miller, Neena
Cornejo, Jennifer
Sullivan, Brian
author_sort O'Connell, Brendon
collection PubMed
description Clear documentation of instructions for resuming anticoagulant and antiplatelet (AC/AP) medications after gastrointestinal endoscopy is essential for high-quality postprocedure care. Yet, these recommendations are frequently absent, which may impact patient safety. We aimed to improve documentation of postprocedural AC/AP instructions through targeted interventions during outpatient endoscopy at a Veterans Affairs Medical Center using validated Quality Improvement methodology. We identified patients on AC/AP agents presenting for outpatient oesophagogastroduodenoscopy or colonoscopy and found restart recommendations were documented in only 59.4% of procedures at baseline. After two intervention cycles, which included provider education, nursing prompts and alterations to endoscopic documentation software, postprocedure documentation increased by 26.7%–86.1% when compared with baseline (p<0.001). These interventions, which require low-resource utilisation, could be part of standardised processes readily implemented at other institutions to help potentially reduce postprocedure patient confusion, medication errors and complications.
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spelling pubmed-97238512022-12-07 Improving documentation of anticoagulation and antiplatelet recommendations after outpatient endoscopy O'Connell, Brendon Boyd, Amanda Kothari, Darshan Miller, Neena Cornejo, Jennifer Sullivan, Brian BMJ Open Qual Quality Improvement Report Clear documentation of instructions for resuming anticoagulant and antiplatelet (AC/AP) medications after gastrointestinal endoscopy is essential for high-quality postprocedure care. Yet, these recommendations are frequently absent, which may impact patient safety. We aimed to improve documentation of postprocedural AC/AP instructions through targeted interventions during outpatient endoscopy at a Veterans Affairs Medical Center using validated Quality Improvement methodology. We identified patients on AC/AP agents presenting for outpatient oesophagogastroduodenoscopy or colonoscopy and found restart recommendations were documented in only 59.4% of procedures at baseline. After two intervention cycles, which included provider education, nursing prompts and alterations to endoscopic documentation software, postprocedure documentation increased by 26.7%–86.1% when compared with baseline (p<0.001). These interventions, which require low-resource utilisation, could be part of standardised processes readily implemented at other institutions to help potentially reduce postprocedure patient confusion, medication errors and complications. BMJ Publishing Group 2022-12-05 /pmc/articles/PMC9723851/ /pubmed/36588305 http://dx.doi.org/10.1136/bmjoq-2021-001725 Text en © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Quality Improvement Report
O'Connell, Brendon
Boyd, Amanda
Kothari, Darshan
Miller, Neena
Cornejo, Jennifer
Sullivan, Brian
Improving documentation of anticoagulation and antiplatelet recommendations after outpatient endoscopy
title Improving documentation of anticoagulation and antiplatelet recommendations after outpatient endoscopy
title_full Improving documentation of anticoagulation and antiplatelet recommendations after outpatient endoscopy
title_fullStr Improving documentation of anticoagulation and antiplatelet recommendations after outpatient endoscopy
title_full_unstemmed Improving documentation of anticoagulation and antiplatelet recommendations after outpatient endoscopy
title_short Improving documentation of anticoagulation and antiplatelet recommendations after outpatient endoscopy
title_sort improving documentation of anticoagulation and antiplatelet recommendations after outpatient endoscopy
topic Quality Improvement Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9723851/
https://www.ncbi.nlm.nih.gov/pubmed/36588305
http://dx.doi.org/10.1136/bmjoq-2021-001725
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