P72 Implementing a standardised electronic digital proforma to improve post-procedure documentation following ascitic paracentesis

IntroductionDocumentation of ascitic procedures (paracentesis and ascitic taps) are often lacking in detail, which can lead to a lower standard of care post-procedure. This can lead to delayed diagnosis of spontaneous bacterial peritonitis (SBP) and administration of antibiotics, delayed removal of drains, omission of human albumin solution (HAS) prescription and incorrect investigations being ordered. All of these can affect quality of care and increase mortality in patients with decompensated cirrhosis.AimThe aim of this project is to review and improve post-procedure documentation following ascitic paracentesis and ascitic taps, by implementing a standardised electronic digital proforma.MethodsOur audit standards were based on the guidance by the British Association for the Study of the Liver (BASL), British Society of Gastroenterology (BSG) and our local trust policy. We audited post-procedure documentation from 1/10/2022 to 28/02/2023 to assess compliance of documentation against our standards. Patients were identified by searching for those who had an ‘ascitic fluid’ order requested through our pathology lab. Our intervention was to design a standardised digital proforma for documenting these procedures on our local electronic patient record systems (ePRS). We have also implemented an electronic prompt to encourage use of the proforma when ordering ascitic fluid on our local pathology system. The electronic proforma was implemented in March 2023. We have subsequently re-audited documentation between 01/04/2023 and 18/06/2023 and compared our performance when the proforma was used with when it was not used post-intervention before and after intervention.ResultsThe pre-intervention audit included 21 cases of paracentesis and 37 of taps. The post-intervention audit included 12 cases of paracentesis and 19 of ascitic taps. The use of the digital proforma in the post-intervention audit significantly improved documentation of ascitic paracentesis when compared to when it was not used; fluid appearance description (71% vs 100%, p