Improving the timeliness and accuracy of diagnostic ascitic taps in a district general hospital: a patient safety initiative

Introduction: Spontaneous bacterial peritonitis (SBP) is a life-threatening complication of ascites that requires timely diagnosis through an ascitic tap. Delays or missed procedures can lead to poor outcomes. Our audit identified suboptimal adherence to NICE and British Society of Gastroenterology...

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Main Authors: Homagni Sikha Roy, Khaled Radwan
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:Future Healthcare Journal
Online Access:http://www.sciencedirect.com/science/article/pii/S2514664525001924
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author Homagni Sikha Roy
Khaled Radwan
author_facet Homagni Sikha Roy
Khaled Radwan
author_sort Homagni Sikha Roy
collection DOAJ
description Introduction: Spontaneous bacterial peritonitis (SBP) is a life-threatening complication of ascites that requires timely diagnosis through an ascitic tap. Delays or missed procedures can lead to poor outcomes. Our audit identified suboptimal adherence to NICE and British Society of Gastroenterology guidelines, contributing to diagnostic delays. We aimed to improve compliance with timely ascitic taps to enhance patient safety and outcomes. Methods: We conducted an initial audit assessing compliance with national guidelines, which recommend performing a diagnostic ascitic tap for suspected SBP within 6 h of admission, with samples sent for cell count, culture and biochemistry. The audit revealed that only 24% of patients had a timely ascitic tap, and 55% of samples lacked complete investigations. Targeted interventions were introduced, including structured teaching sessions for clinicians on SBP recognition, practical training on ascitic tap technique, reminder posters in acute areas and email reminders to clinical staff. Results: A re-audit demonstrated a significant improvement in compliance. The proportion of ascitic taps performed within 6 h increased from 24% to 45%. Adherence to sending appropriate investigations improved from 45% to 71%. Clinician confidence in performing ascitic taps increased following the educational interventions. Conclusion: Our findings highlight that delays in ascitic taps often result from knowledge gaps and procedural hesitancy. Targeted education and clear protocols significantly improved adherence to guidelines, enhancing patient safety. Embedding sustainable changes, such as reminder tools, and maintaining ongoing education and re-audits are essential for ensuring continued improvements in the timely diagnosis and management of SBP.
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spelling doaj-art-ded52b8d70be429f9567618fcd5125dc2025-08-20T03:32:16ZengElsevierFuture Healthcare Journal2514-66452025-06-0112210041310.1016/j.fhj.2025.100413Improving the timeliness and accuracy of diagnostic ascitic taps in a district general hospital: a patient safety initiativeHomagni Sikha Roy0Khaled Radwan1Betsi Cadwaladr University Health BoardBetsi Cadwaladr University Health BoardIntroduction: Spontaneous bacterial peritonitis (SBP) is a life-threatening complication of ascites that requires timely diagnosis through an ascitic tap. Delays or missed procedures can lead to poor outcomes. Our audit identified suboptimal adherence to NICE and British Society of Gastroenterology guidelines, contributing to diagnostic delays. We aimed to improve compliance with timely ascitic taps to enhance patient safety and outcomes. Methods: We conducted an initial audit assessing compliance with national guidelines, which recommend performing a diagnostic ascitic tap for suspected SBP within 6 h of admission, with samples sent for cell count, culture and biochemistry. The audit revealed that only 24% of patients had a timely ascitic tap, and 55% of samples lacked complete investigations. Targeted interventions were introduced, including structured teaching sessions for clinicians on SBP recognition, practical training on ascitic tap technique, reminder posters in acute areas and email reminders to clinical staff. Results: A re-audit demonstrated a significant improvement in compliance. The proportion of ascitic taps performed within 6 h increased from 24% to 45%. Adherence to sending appropriate investigations improved from 45% to 71%. Clinician confidence in performing ascitic taps increased following the educational interventions. Conclusion: Our findings highlight that delays in ascitic taps often result from knowledge gaps and procedural hesitancy. Targeted education and clear protocols significantly improved adherence to guidelines, enhancing patient safety. Embedding sustainable changes, such as reminder tools, and maintaining ongoing education and re-audits are essential for ensuring continued improvements in the timely diagnosis and management of SBP.http://www.sciencedirect.com/science/article/pii/S2514664525001924
spellingShingle Homagni Sikha Roy
Khaled Radwan
Improving the timeliness and accuracy of diagnostic ascitic taps in a district general hospital: a patient safety initiative
Future Healthcare Journal
title Improving the timeliness and accuracy of diagnostic ascitic taps in a district general hospital: a patient safety initiative
title_full Improving the timeliness and accuracy of diagnostic ascitic taps in a district general hospital: a patient safety initiative
title_fullStr Improving the timeliness and accuracy of diagnostic ascitic taps in a district general hospital: a patient safety initiative
title_full_unstemmed Improving the timeliness and accuracy of diagnostic ascitic taps in a district general hospital: a patient safety initiative
title_short Improving the timeliness and accuracy of diagnostic ascitic taps in a district general hospital: a patient safety initiative
title_sort improving the timeliness and accuracy of diagnostic ascitic taps in a district general hospital a patient safety initiative
url http://www.sciencedirect.com/science/article/pii/S2514664525001924
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