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Delay in Transit: selected recommendations from the NCEPOD report on acute bowel obstruction
Martin Sinclair1, Alison Culkin2, Andrew C Douds3,4
1The National Confidential Enquiry into Patient Outcome and Death (NCEPOD), London, UK.
Frontline Gastroenterology
|May 2, 2022
Summary
Delays in diagnosis, treatment, and basic care, including nutrition, impact patients with acute bowel obstruction (ABO). Improvements are needed at all stages of patient care pathways.
Area of Science:
- Gastroenterology
- Surgical Patient Care
Background:
- The National Confidential Enquiry into Patient Outcome and Death (NCEPOD) report identified critical issues in acute bowel obstruction (ABO) patient care.
- Significant delays were observed across all stages of the clinical pathway for ABO patients.
Purpose of the Study:
- To highlight deficiencies in the care of patients with acute bowel obstruction.
- To discuss recommendations for improving patient outcomes based on the NCEPOD report.
Main Methods:
- Analysis of the NCEPOD report on acute bowel obstruction.
- Review of care pathways, including diagnosis, decision-making, and operating theatre availability.
- Assessment of nutritional screening and hydration practices.
Main Results:
- Delays were prevalent at every stage: diagnosis, decision-making, and surgical intervention.
- Basic care, including hydration and nutritional assessment, was frequently deficient.
- Admission to non-surgical wards increased risk of delayed treatment and prolonged starvation.
Conclusions:
- Urgent improvements are required in the clinical pathway management of acute bowel obstruction.
- Enhanced nutritional screening and assessment are crucial throughout the patient's hospital journey.
- Optimizing care pathways and basic supportive measures can improve outcomes for ABO patients.
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