TPT 6.07 Treatment Escalation Plan Documentation in Emergency Surgical Admissions: A Multi-Site Audit

Le résumé fourni par la source

Abstract Aim Treatment Escalation Plans (TEPs) facilitate timely and patient-centred decision-making during episodes of clinical deterioration, extending beyond cardiopulmonary resuscitation (CPR) status. This audit examined the prevalence, timeliness, and quality of TEP documentation at two hospital sites. Methods A retrospective review was conducted on 200 consecutive adult acute surgical admissions across two district general hospitals. Variables assessed included patient age, presence of a TEP, time to TEP completion, CPR status documentation, capacity assessment, and discussion of patient preferences. Data were analysed using descriptive methods. Results The mean age of the cohort was 62 years (range: 18–99). TEPs were documented for 39 patients (19.5%), with those patients generally older than those without TEPs (mean age 80 versus 56.6 years). Of these 39 TEPs, 21 (53.8%) were completed within 24 hours, 6 (15.4%) within 72 hours, and 12 (30.8%) after 72 hours. CPR status was consistently recorded for all admissions, whereas capacity assessments were noted in 34 cases (17%) and patient preferences in 14%. Conclusion While CPR decisions were uniformly documented, comprehensive use of TEPs in acute surgical admissions remains limited, often delayed, and frequently lacks documentation regarding patient capacity and preferences. Enhancing early completion and improving documentation quality may promote safer and more consistent escalation decisions, especially during off-hours and clinical handover. These findings were comparable between both sites, indicating widespread workflow and documentation challenges within General Surgery.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.