Endocrine Abstracts

Background: Peri-operative guidelines (POG) published early 2020, were followed by the NHS National Patient Safety Alert (NatPSA) and launch of the NHS Steroid Emergency Card (SEC) in Aug 2020. The NatPSA was sent to all NHS health and care providers. This survey was undertaken to assess the implementation and impact of both.

Methods: A pilot survey was undertaken at Endocrine Nurse Update 2022 and amended survey emailed to the SfE membership. 106 participants responded to the first question with 84 completing the remaining questions. Respondents were a mix of Doctors and Nurses from the UK.

Key Outcomes: 59% of responders agreed the POG had made it easier to give advice on steroid management vs 9% who disagreed. IV infusion of Hydrocortisone is used in perioperative care but less than IV/IM bolus. 61.5% of local guidelines incorporated the POG guidelines, 16.9% “did not know” and 21.7% reported “No” to incorporation into local guidelines. 53% of respondents reported local Trust strategies to implement the NatPSA alert however 33.7% of respondents were not aware of the local NatPSA strategy. Confidence that patients received the SEC was high: >70% in primary and secondary adrenal insufficiency, vs 58% in tertiary. 41.7% confirmed their Trust had an alert system to identify inpatients on glucocorticoid treatment. 11.9% did not know.

Conclusion: Findings of this survey suggest the POG have been helpful in clinical practice. Whist there has been good uptake of the NatPSA in some organisations, this survey demonstrates a need for Trust’s to improve processes in order to ensure safe practice for patients with adrenal insufficiency is implemented. Communication of NatPSA needs to improve, alongside organisations communication and compliance of the NatPSA. As endocrine clinicians we should be leading this work in our organisations.