Improving documentation of anticoagulation and antiplatelet recommendations after outpatientendoscopy

BMJ Open Qual. 2022 Dec;11(4):e001725. doi: 10.1136/bmjoq-2021-001725.

Abstract

Clear documentation of instructions for resuming anticoagulant and antiplatelet (AC/AP) medications after gastrointestinal endoscopy is essential for high-quality postprocedure care. Yet, these recommendations are frequently absent, which may impact patient safety. We aimed to improve documentation of postprocedural AC/AP instructions through targeted interventions during outpatient endoscopy at a Veterans Affairs Medical Center using validated Quality Improvement methodology. We identified patients on AC/AP agents presenting for outpatient oesophagogastroduodenoscopy or colonoscopy and found restart recommendations were documented in only 59.4% of procedures at baseline. After two intervention cycles, which included provider education, nursing prompts and alterations to endoscopic documentation software, postprocedure documentation increased by 26.7%-86.1% when compared with baseline (p<0.001). These interventions, which require low-resource utilisation, could be part of standardised processes readily implemented at other institutions to help potentially reduce postprocedure patient confusion, medication errors and complications.

Keywords: COLONOSCOPY; ENDOSCOPY; Medication Reconciliation.

MeSH terms

  • Anticoagulants / adverse effects
  • Colonoscopy
  • Documentation
  • Endoscopy, Gastrointestinal*
  • Humans
  • Medication Errors*
  • Platelet Aggregation Inhibitors / adverse effects

Substances

  • Anticoagulants
  • Platelet Aggregation Inhibitors