Background Paracentesis is commonly used for drainage of malignant ascites in the palliative setting with 90% of patients reporting improvement of symptoms following the procedure. Despite this, there is limited evidence surrounding best practice and there are currently no national paracentesis standards.
Aims To assess whether paracentesis standards are being met in practice, to compare with the results of 2010 audit and identify areas for improvement.
Method A retrospective analysis of all paracentesis procedures carried out in 2015 was done by searching for and analysing procedures documented on SystmOne (patient electronic record).
Results 41 procedures were performed on 10 patients, with average of 83% of standards met. All procedures had informed consent, INR documented and were done with appropriate anaesthetic and equipment. 98% were preceded by ultrasound, compared with 43% in 2010. Fewer procedures met the standards regarding documentation of observations and drain removal. PRN analgesia was prescribed in 85% of cases. The main complication was leakage post -drain removal.
Conclusions Results demonstrate more procedures are being done, with ultrasound now being used regularly to identify a safe drainage site. Recommendations were made to improve documentation of the insertion, observations and drain removal by altering the paracentesis template on SystmOne. Further action is to discuss the need for hourly observations and to research and review prevention and management of leaking from the drain site.
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