Fraser Health Authority Nurse Practitioner Gastrointestinal Prophylaxis Audit in Acute Care

Abstract

Each year, the Fraser Health Authority (FHA) Regional Department Medical Quality Committee (RDMQC) of the Department of Nurse Practitioners (NP) conducts a clinical chart audit that focuses on a specific disease or condition. Due to increased interest as well as questions regarding the correct use of this practice in acute care, for the 2022 and 2023 FHA clinical chart audit, GI prophylaxis was the selected topic for acute care nurse practitioners. The aim of the FHA NP GI prophylaxis audit in acute care was to understand the practice patterns of NPs prescribing gastroprotective agents in the FHA acute care population, indications for prescribing, and criteria used to identify those at risk for GI bleeds. Once the 2022 audit was completed and analyzed, an educational tool was developed and distributed to all acute care NPs in an effort to improve GI prophylaxis practice. In 2023 NPs were asked to complete the GI prophylaxis chart audit for a second time. Following the delivery of the GI prophylaxis educational tool, there is a reported increased awareness amongst acute care FHA NPs on the topic of GI prophylaxis, and improved prescribing practices. When compared to the 2022 chart audit, the 2023 chart audit data revealed that more often than previously, NPs have critically evaluated patients' need for GI prophylaxis, used risk assessment tools to identify high risk patients for GI bleed, provided teaching to patients about GI prophylaxis and assessed indications of prescribing and deprescribing GI prophylaxis.