Chest drain care bundle: Improving documentation and safety.

Area of Science:

• Medical Procedures
• Patient Safety
• Quality Improvement

Background:

• Chest drain insertion is a common procedure with inherent risks of pain, distress, and complications.
• National audits reveal significant safety concerns and poor documentation practices regarding premedication, ultrasound guidance, and consent for chest drains.
• Inadequate documentation poses risks to patient safety, necessitating targeted improvement efforts.

Purpose of the Study:

• To quantify current chest drain insertion documentation standards.
• To improve documentation through accessible guidelines, education, and a standardized chest drain insertion bundle.
• To enhance patient safety by addressing identified documentation deficits.

Main Methods:

• National best practice standards were identified through guidance review.
• Chest drain insertions were prospectively audited over three months to establish baseline documentation.
• A chest drain insertion bundle and clinical guidelines were developed and implemented, followed by a reaudit.

Main Results:

• Documentation quality significantly improved, exceeding national averages in several areas.
• The new bundle was utilized in 40% of cases, influenced by staff rotation and emergency insertions.
• Despite incomplete bundle adoption, accessible guidance and the bundle markedly improved documentation.

Conclusions:

• Accessible guidelines and a chest drain insertion bundle demonstrably improve documentation for this procedure.
• Addressing documentation gaps in chest drain insertion enhances patient safety.
• Continued efforts are needed to ensure consistent bundle adoption across all insertion settings.