scholarly journals An Audit on "Atrial Fibrillation & Anti-Coagulation" at University Hospitals of North Midlands NHS Trust (2015-2017)

2020 ◽  
pp. 1-3
Author(s):  
M.I.A Qureshi ◽  
M.I.A Qureshi ◽  
Anil Kumar ◽  
Anil K Miryala
Keyword(s):  
Atrial Fibrillation ◽  
Patient Safety ◽  
Subdural Haematoma ◽  
Significant Risk ◽  
Analysis Data ◽  
University Hospital ◽  
Prospective Audit ◽  
University Hospitals ◽  
Onset Atrial Fibrillation ◽  
New Onset

Background: During hospital admission, it was noticed that most patients with atrial fibrillation (new or old) diagnosis have no clear documented plan about anticoagulation. It was considered a significant risk for patient safety. Aim: To determine whether patients with atrial fibrillation diagnosis were on anticoagulation or not, if not have the reasons been documented in the medical notes. If new-onset atrial fibrillation whether CHADSVASC and HASBLED scores have been used or not for anticoagulation purpose. Settings: County Hospital Stafford & Royal Stoke University Hospital (UHNM 2015-2017). Materials and Methods: Prospective audit, a total of 100 patient's data (50 patients per cycle) were analysed by using specific audit Performa based upon NICE Atrial Fibrillation 2014 Guidelines [1]. Statistical Analysis: Data was coded, entered in an excel spreadsheet and analysed by translating into percentages and proportions. Results: Initial audit showed that out of 50 patients with atrial fibrillation diagnosis, 30 were already on anticoagulation and 20 were not on anticoagulation. Only 2 out of 20 were assessed for anticoagulation and 18 were not assessed. AF Performa was introduced in the clerking sheet post initial audit. Re-audit after 6 months showed 43 out of 50 patients were on anticoagulation and 7 were not. Out of these 7 patients, 3 patients had absolute contraindications (Subdural Haematoma, Rectal bleeding and major haematoma), 2 patients were assessed for anticoagulation however were not followed up and 2 were not assessed. Results comparison is explained in (Table 1). Conclusions: This audit has demonstrated significant improvement in overall anticoagulation rates in suitable patients which have helped in improving patient safety.

scholarly journals Frequent drinking is a more important risk factor for new-onset atrial fibrillation than binge drinking: a nationwide population-based study

EP Europace ◽  
2019 ◽  
Author(s):  
Yun Gi Kim ◽  
Kyung-Do Han ◽  
Jong-Il Choi ◽  
Ki Yung Boo ◽  
Do Young Kim ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Risk Factor ◽  
Alcohol Consumption ◽  
Binge Drinking ◽  
Alcohol Intake ◽  
Significant Risk ◽  
Drinking Session ◽  
Onset Atrial Fibrillation ◽  
Frequent Drinking ◽  
New Onset

Abstract Aims Heavy consumption of alcohol is a known risk factor for new-onset atrial fibrillation (AF). We aimed to evaluate the relative importance of frequent drinking vs. binge drinking. Methods and results A total of 9 776 956 patients without AF who participated in a national health check-up programme were included in the analysis. The influence of drinking frequency (day per week), alcohol consumption per drinking session (grams per session), and alcohol consumption per week were studied. Compared with patients who drink twice per week (reference group), patients who drink once per week showed the lowest risk [hazard ratio (HR) 0.933, 95% confidence interval (CI) 0.916–0.950] and those who drink everyday had the highest risk for new-onset AF (HR 1.412, 95% CI 1.373–1.453), respectively. However, the amount of alcohol intake per drinking session did not present any clear association with new-onset AF. Regardless of whether weekly alcohol intake exceeded 210 g, the frequency of drinking was significantly associated with the risk of new-onset AF. In contrast, when patients were stratified by weekly alcohol intake (210 g per week), those who drink large amounts of alcohol per drinking session showed a lower risk of new-onset AF. Conclusion Frequent drinking and amount of alcohol consumption per week were significant risk factors for new-onset AF, whereas the amount of alcohol consumed per each drinking session was not an independent risk factor. Avoiding the habit of consuming a low but frequent amount of alcohol might therefore be important to prevent AF.

scholarly journals Slow Down: New-Onset Atrial Fibrillation Challenges for Ambulatory Surgical Facilities

2021 ◽  
pp. 39-41
Author(s):  
Melanie Motts ◽  
Lea Anne Gardner
Keyword(s):  
Atrial Fibrillation ◽  
Patient Safety ◽  
Healthcare Facilities ◽  
Safety Reporting ◽  
Cardiac Monitor ◽  
Medical Issues ◽  
Increased Risk ◽  
Act One ◽  
Onset Atrial Fibrillation ◽  
New Onset

As patient safety liaisons (PSLs), we are continually educating and collaborating with our Pennsylvania healthcare facilities. We often are asked questions about reportable events under the Medical Care Availability and Reduction of Error (MCARE) Act. One of the most common examples we discuss is cancellations and transfers out of an ambulatory surgical facility (ASF). The top three reasons for cancellations include preop instructions not followed, missed medical issues identified during preop screening, and no shows. The top three reasons for transfers include cardiac arrhythmias, aspiration, and hypertension. Interestingly, between discussions with facilities and review of event reports, new-onset atrial fibrillation (AF) has come up often as a common reason for cancellations or transfers out of the ASF setting, especially in gastrointestinal (GI) procedures. In fact, as PSLs, when educating ASFs on reportable events we often give the example of placing a patient on the cardiac monitor in preop and the patient is found to be in AF. In 2009, it was estimated that 13.1% of AF cases were undiagnosed,3 which may explain why patients are presenting with new-onset AF. People with AF are at an increased risk of complications (e.g., stroke);3,4 therefore, a cancellation or transfer may be necessary depending on the patient’s condition. These events are considered reportable to the Pennsylvania Patient Safety Reporting System (PA-PSRS) under MCARE.

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