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B126 Novel peripheral nerve block quality improvement project focusing on supporting clinical delivery and teaching
  1. Z Milovanovic1,2,
  2. I-A Tribe1 and
  3. A Wilkinson1
  1. 1Homerton Univeristy Hospital, London, UK
  2. 2Royal London Hospital, London, UK


Background and Aims We designed and implemented a novel quality improvement (QI) project at Homerton University Hospital (HUH), based on the NICE1and Royal College of Anaesthetists (RCoA) guidelines2covering peripheral nerve block (PNB) provision, training and education, and audit.

Methods The QI project developed novel ‘service provision’ to support the delivery and training of PNBs (see driver diagram in figure 1). We undertook a pilot study assessing efficacy and viability of the teaching programme and the formal follow up of patients who had PNBs. The pilot evaluated the practical application and stakeholder’s experiences: teaching via feedback forms, and patient’s during the follow up.

Secondly, we audited the formal patient follow-up, feedback from teaching sessions and the audit of ‘Stop before you Block’ (SBYB), presenting the results and gaining approval from the QI team and Clinical Director.

Driver Diagram

Results We implemented the following changes indefinitely:

1. Teaching and training

  1. Monthly ‘ultrasound scanning club’

  2. Trainee PNB opportunities on theatre list

  3. 2. Service provision-

  4. Telephone follow-up of patients 48 hours post peripheral nerve block

  5. New SBYB approach poster in anaesthetic rooms

  6. New HUH PNB consent stickers (figure 2) and patient leaflet (figure 3)

Conclusions We developed a new system to support the clinical delivery of PNBs through patient follow up, documentation of consent, audit of practice and a teaching programme, which increases patient safety and provides standardisation in practice. The changes implemented were tested in a pilot, and audited, gaining approval through stakeholder buy-in that will ensure longevity and growth.

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