SFEBES2021 Poster Presentations Neuroendocrinology and Pituitary (47 abstracts)
Digital transformation of a hyponatraemia toolkit: impact on clinical practice
Amna Zeeshan 1 , Senan Devendra 1 , Christina O’Dowd 1 , Pooja Shah 1 , Roshni Goodka 1 , Ruben Devendra 2 , Sayed Obaidee 1 & Bharat Patel 1
1West Hertfordshire Hospitals NHS Trust, Watford, United Kingdom; 2Cardinal Vaughan Memorial School, London, United Kingdom
Hyponatraemia is associated with an increased morbidity and mortality. Despite having a hyponatraemia algorithm (pdf format) on our hospital intranet, it was rarely accessed and a wide variation in care was noticed. A novel digital hyponatraemia diagnostic toolkit (hyponatraemia.wordpress.com) for Foundation doctors (FDs) was introduced to assess our aims if it: A) increases the awareness of FDs to start investigating when serum Sodium is <130 mmol/l B) increases FDs confidence in managing hyponatraemia (self-rated scale 1 to 5) C) reduces variation in care by using the Bartter-Schwartz (BS) criteria to diagnose SIADH D) increases the minimum standard of care (MSOC) (Urine osmolality, urine sodium, Plasma osmolality requested within 24 hours of admission) E) reduces length of stay (LOS) in hospital A survey was sent to FDs before and after the digital toolkit to investigate aims A to C. The LOS and MSOC was assessed for the first 25 consecutive patients admitted with hyponatraemia (< 130) in the month of October 2020 and re-assessed once the digital toolkit was launched. Out of 25 responses from FDs, 68% would investigate at a level less than 130 mmol/l , this increased to 100% after the digital toolkit. Mean (SD) confidence in managing hyponatraemia increased from 2.55 (±0.83) to 3.87 (±0.45); P = 0.01. 100% of FDs followed the BS criteria compared with 5% prior to the toolkit. A 60% increase in MSOC was noted after the toolkit. The mean LOS was 7.2 (±3.2) days and dropped to 4.6 (±2.4) after the toolkit (P = 0.01). This novel digital hyponatraemia toolkit increased FDs confidence and awareness in managing this common condition. Within a small group of patients, it improved the variation and efficiency in patient care. The referral rate to the endocrine team are currently being analysed. A larger multi-hospital study would help determine if these results are replicable.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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