Timely Labour Epidural A Reaudit of Epidural Response

Timely Labour Epidural: A Re-audit of Epidural Response Time in a Tertiary Obstetric Hospital Lie J – ST 7 in Anaesthesia, North Western Deanery Wai C – ST 7 in Anaesthesia, North Western Deanery Howells A – Consultant Anaesthetist, Central Manchester University Hospitals NHS Foundation Trust Saint Mary’s Hospital, Central Manchester University Hospitals NHS Foundation Trust Background • Reconfiguration of obstetric services lead to increase in delivery rate & change of obstetric anaesthetic cover Royal College of Anaesthetists Standard “> 80% of women should be seen by the anaesthetist • within 30 min of being requested to provide epidural analgesia, & 100% by 60 min. ” [1] • • • Initial audit responses : 108 Responses Total recorded epidural on CMi. S: 146 Audit response rate: 74% Total deliveries in June 2014: 716 cases Epidural rate: 146/546 labourers (26. 7%) • • Methods Prospective audit Proforma completed by anaesthetists after performing epidural procedure Between 1 st – 30 th June 2014 Missing data identified retrospectively via K 2 Results • • 48% of epidurals were performed by ST 5 -7 Main indication was maternal request • • • Average response time = 25 mins & 11 secs Response within 30 minutes: 78. 08% 2. 74% incomplete Epidurals >1 hour wait Comparison with previous audits Busiest Shifts Discussion • • Encouraging results compare to last audit but still short of the targets at 30 mins & 60 mins Increase in workload & epidural rates Recommendations • • • Consider bloods once patient is for induction of labour Re-education of midwives Early consideration of alternative analgesia References [1] Pickering E & Holdcroft A. Response times for provision of intrapartum analgesia and anaesthesia. Raising the Standard: a compendium of audit recipes. The Royal College of Anaesthetists, 2012