BSG EQIP UPPER GI HAEMOSTASIS COURSE QUALITY IMPROVEMENT PROJECT

Aims The aim of this project was to assess the knowledge and skills of medical and paramedical staff in managing the Upper Gastro-intestinal bleeding (UGIB), pre- and post-UGIB haemostasis course and the benefits of conducting it.

Methods A one-day course in line with British Society of Gastroenterology’s Endoscopy Quality Improvement Project initiative and in conjunction with Joint Advisory Group

was arranged at Sheffield Teaching Hospitals on 10^Th October, 2019 for all medical and para-medical including gastroenterology fraternity. The course included lectures on pre-endoscopic consideration, risk assessment, potential pathologies responsible for UGIB, management of variceal, non-variceal and atypical UGIB and endoscopy report writing. Subsequently, hands-on training on adrenaline injection, clip placement, variceal banding, thermal therapy, haemostatic powder (Hemospray), Sengstaken tube and Danis stent placement was also arranged via porcine or plastic models. Feedback questionnaires consisting of self-assessed pre and post course ratings related to knowledge, skills and behaviour relevant to UGIB were offered to all delegates. Wilcoxon signed-rank tests were used to compare the results.

Results The course was attended by 36 delegates hailing from different fields of specialization and seniority (both medical and paramedical) with an average endoscopy procedure count of 583. Out of which, ten were JAG certified in UGI endoscopy. Four were Gastroenterology consultants, one surgical consultant, eight were gastroenterology trainees, two medicine trainees, one surgical trainee, two junior doctors with remaining ones being nurses or nurse practitioners. Feedback datasheets were returned by 22 delegates. Significant improvements were reported post course in almost all areas, especially the hands-on and behavioural components (table 1).

Conclusions The confidence in managing UGIB independently of the delegates improved significantly with this one-day haemostasis course. Conducting such courses at regular intervals for all medical and paramedical staff especially the gastroenterology trainees, will help to improve management of UGIB, thus reducing the mortality and morbidity rate nationally.