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Abdominal Pain CPI
Clinical scenario
Patients presenting to the ED with abdominal pain make up about 5% of all attenders. Previous studies have shown poor agreement between the initial ED clinicians assessment and the final clinical diagnosis. Most frequently the cause is benign and/or self-limited, but more serious causes may require urgent intervention.
Audit question
Is abdominal pain managed appropriately according to best practice guidelines?
Method
Retrospective audit
Sample: 30-50 Emergency Department patient records
Criteria
Inclusions: Patients presenting with abdominal pain
Exclusions: Patients presenting with other medical conditions
Audits
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1st April 2009
Results
| Date | Patients | Measured | Results | Standard | Regional avg. |
|---|---|---|---|---|---|
| 01st April 2009 | Patients attending the ED with abdominal pain. | Management of patients according to the criteria. | Pain relief given within 20 minutes of arrival if appropriate | 100 % | 17 % |
| Pregnancy test in all females of child bearing age or known confirmed pregnancy documented | 100 % | 69 % | |||
| Abdominal examination documented | 100 % | 98.5 % | |||
| Pain score on arrival | 100 % | 75 % | |||
| Pain relief appropriate to pain score | 100 % | 79.6 % |
Comments
Huge decline in scores for timeliness of pain relief and use of pain score, but otherwise a reasonable set of results.
Audit Bottom Line
Work required around pain scoring and pain relief, and continued improvement in all other criteria.