|Title:||An audit of the Documentation of Well’s score and or D-Dimers for CTPA requests in the Mater Misericordiae University Hospital|
|Author(s):||D. McMorrough J. Kahn S. Gaine|
|Institution:||Mater Misericodiae University Hospital|
|Poster:||Click to view poster|
|Category:||General Respiratory and Sleep|
|Abstract:||HSE & Mater Misercordiae University Hospital (MMUH) guidelines state a patient requiring a CTPA should have both D-Dimer and Wells score documented on the order. |
This study aimed to review CTPA orders made over 2 discreet 7-day periods in January (n=38) and May 2020 (n=33) in cases where Pulmonary Embolus was suspected. There orders were examined to evaluate the proportion of CTPA orders that took D-Dimer, Well’s Score or both into account, in accordance with the agreed standard of care.
While no CTPA ordered during the study period took both metrics into account, there was a significant increase in the proportion of orders that mentioned D-Dimer levels from 24% in January to 58% of orders made in May. The proportion of orders that included a Well’s score fell from 15% to 3% from January to May.
While there was an increase in the proportion of orders that recorded D-Dimers, there is still significant room for improvement the ordering of CTPA scans. In particular, when coupled with the negative predictive value of D-Dimer levels, the inclusion of a Wells score could help reduce the burden of unnecessary scans on both patients and the radiology departments across the HSE.