Zeroing in: achieving zero complications in lumbar puncture – a quality improvement initiative to reduce complications at the University Hospital of North Norway

Background Lumbar puncture (LP) is an essential diagnostic procedure in neurology, but carries risk, with post-lumbar puncture headache being the most frequent complication. In 2017, a severe complication with intracranial haemorrhage following LP in Northern Norway led to an evaluation of LP proced...

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Main Authors: Susanne Gaarden Ingebrigtsen, Agnethe Eltoft, Thomas Karsten Kilvaer
Format: Article
Language:English
Published: BMJ Publishing Group 2025-06-01
Series:BMJ Open Quality
Online Access:https://bmjopenquality.bmj.com/content/14/2/e003327.full
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author Susanne Gaarden Ingebrigtsen
Agnethe Eltoft
Thomas Karsten Kilvaer
author_facet Susanne Gaarden Ingebrigtsen
Agnethe Eltoft
Thomas Karsten Kilvaer
author_sort Susanne Gaarden Ingebrigtsen
collection DOAJ
description Background Lumbar puncture (LP) is an essential diagnostic procedure in neurology, but carries risk, with post-lumbar puncture headache being the most frequent complication. In 2017, a severe complication with intracranial haemorrhage following LP in Northern Norway led to an evaluation of LP procedures and resulted in the development of a new unified regional procedure.Local problem At the University Hospital of North Norway (UNN), 10% of LPs performed in 2017 resulted in a complication. A survey identified gaps in protocol adherence, physician training, and patient education.Intervention Aiming to reduce LP complication rates from 10% to 1% by January 2019, we implemented standardised protocols, introduced smaller gauge needles, enhanced physician training and improved patient education.Results Complication rates dropped to 1%, achieving 107 consecutive complication-free procedures by January 2019, with sustained improvement over subsequent years.Conclusion Standardised protocols, physician training, introduction of smaller gauge needles and patient education significantly reduced LP complications. Educating patients on expectations and post-procedure care was critical in preventing unnecessary admissions and outpatient visits.
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issn 2399-6641
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spelling doaj-art-d8a17dde22e446a5834029552bb17ad12025-08-20T03:45:14ZengBMJ Publishing GroupBMJ Open Quality2399-66412025-06-0114210.1136/bmjoq-2025-003327Zeroing in: achieving zero complications in lumbar puncture – a quality improvement initiative to reduce complications at the University Hospital of North NorwaySusanne Gaarden Ingebrigtsen0Agnethe Eltoft1Thomas Karsten Kilvaer2Department of Neurology, University Hospital of North Norway, Tromsø, NorwayDepartment of Neurology, University Hospital of North Norway, Tromsø, NorwayFaculty of Health Sciences/Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, NorwayBackground Lumbar puncture (LP) is an essential diagnostic procedure in neurology, but carries risk, with post-lumbar puncture headache being the most frequent complication. In 2017, a severe complication with intracranial haemorrhage following LP in Northern Norway led to an evaluation of LP procedures and resulted in the development of a new unified regional procedure.Local problem At the University Hospital of North Norway (UNN), 10% of LPs performed in 2017 resulted in a complication. A survey identified gaps in protocol adherence, physician training, and patient education.Intervention Aiming to reduce LP complication rates from 10% to 1% by January 2019, we implemented standardised protocols, introduced smaller gauge needles, enhanced physician training and improved patient education.Results Complication rates dropped to 1%, achieving 107 consecutive complication-free procedures by January 2019, with sustained improvement over subsequent years.Conclusion Standardised protocols, physician training, introduction of smaller gauge needles and patient education significantly reduced LP complications. Educating patients on expectations and post-procedure care was critical in preventing unnecessary admissions and outpatient visits.https://bmjopenquality.bmj.com/content/14/2/e003327.full
spellingShingle Susanne Gaarden Ingebrigtsen
Agnethe Eltoft
Thomas Karsten Kilvaer
Zeroing in: achieving zero complications in lumbar puncture – a quality improvement initiative to reduce complications at the University Hospital of North Norway
BMJ Open Quality
title Zeroing in: achieving zero complications in lumbar puncture – a quality improvement initiative to reduce complications at the University Hospital of North Norway
title_full Zeroing in: achieving zero complications in lumbar puncture – a quality improvement initiative to reduce complications at the University Hospital of North Norway
title_fullStr Zeroing in: achieving zero complications in lumbar puncture – a quality improvement initiative to reduce complications at the University Hospital of North Norway
title_full_unstemmed Zeroing in: achieving zero complications in lumbar puncture – a quality improvement initiative to reduce complications at the University Hospital of North Norway
title_short Zeroing in: achieving zero complications in lumbar puncture – a quality improvement initiative to reduce complications at the University Hospital of North Norway
title_sort zeroing in achieving zero complications in lumbar puncture a quality improvement initiative to reduce complications at the university hospital of north norway
url https://bmjopenquality.bmj.com/content/14/2/e003327.full
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