1028 Why Is Changing Old Habits So Hard?
M Kronberga, S Suresan, E Cartner, M Khawgali, C Bonner, M Matias, A Saha, M Peter- Surgery
Abstract
Aim
Acute uncomplicated diverticulitis (AUD) has been traditionally managed by inpatient admission for bowel rest, intravenous antibiotics, and fluids. World Society of Emergency Surgery (WSES) updated their guidelines in 2020 recommending that patients with AUD with no significant co-morbidities or immunocompromise should be treated in an ambulatory setting. This full audit cycle aimed to assess the compliance with these guidelines at our trust.
Method
Retrospective data collection was conducted from June 2021 to July 2021 (1st cycle). Inclusion criteria was applied: CT proven AUD, patients below the age of 80 with the ability to tolerate oral intake, had full mental capacity and were not immunocompromised. Educational sessions for clinicians and nurses were implemented to inform of current guidelines. Data was re-audited from June 2022 to July 2022 (2nd cycle).
Results
The first cycle included a total of 31 patients with AUD matching our inclusion criteria where 45% of patients were treated via ambulatory care. Two patients had re-presented but didn’t require admission. The second cycle had a total of 19 patients 47% of which were managed ambulatory. Average length of hospital stay between the inpatient and outpatient groups were 2-3 days versus 4.5 hours.
Conclusions
The compliance rate with current guidelines increased by 2%, however remained low. With low re- presentation rates and re-admission rates, this audit shows that patients with AUD could be safely managed in ambulatory setting. Shifting engrained mindsets and improving compliance with the current guidelines could greatly save NHS resources and alleviate existing bed pressures.