Improving management of oesophageal varices in patients with cirrhosis

Abstract

Disseminating guidelines had little effect on primary prevention practice. Less than 1 year after a nurse coordinator was introduced to manage primary prevention, adherence to primary prevention guidelines increased from 13% to 79%. However, significant improvements in the management of acute variceal bleeding where medical staff have a clear responsibility for patient care were achieved through the development and dissemination of clear clinical protocols and the introduction of auditing and feedback mechanisms.

Optimisation of hepatocellular carcinoma surveillance in patients with viral hepatitis: a quality improvement study

“…The aim of this paper was therefore to investigate the utility of a specific methodology designed to improve HCC surveillance rates. The methodology chosen was based on clinical practice improvement principles, which have demonstrated effectiveness in both non‐medical and medical settings …”

“…The methodology chosen was based on clinical practice improvement principles, which have demonstrated effectiveness in both non-medical and medical settings. [12][13][14]…”

Hospital‐level balloon tamponade use is associated with increased mortality for all patients presenting with acute variceal haemorrhage

“…The increased overall mortality associated with higher BT utilization use should be addressed in multiple ways. Previous reports have suggested improved adherence with quality measures using electronic order sets, checklists, house‐staff educational programmes and by installing a dedicated bleeding nurse to co‐ordinate care . No prior quality improvement intervention, however, has aimed to improve the rate or effectiveness of band ligation.…”

“…Previous reports have suggested improved adherence with quality measures using electronic order sets, 14 checklists, house-staff educational programmes 15 and by installing a dedicated bleeding nurse to co-ordinate care. 16 No prior quality improvement intervention, however, has aimed to improve the rate or effectiveness of band ligation. It is conceivable that efforts to increase the utilization of pre-endoscopy erythromycin 17 could improve visualization and increase the success of band-ligation, though further research is needed.…”

Interprofessional learning and practice can make a difference

“…1 The evidence base in this field is more developed than is acknowledged by its critics, with a range of literature describing the association between IPL and IPP and quality of patient care, health outcomes or teamwork. 4,5,[7][8][9][10] In 2010, Australia hosted an international IPP conference which attracted over 400 academic and health practitioners, 11 many of whom reported associations between IPL, IPP and improvement in patient care.…”