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NBT Pre-operative Elective AAA Care Pathway

Community referral/screen detected AAA. Within hospital referral AAA. AAA -give leaflet. No AAA. OPD. Discharge. <5.5cm. >5.5cm/ symptoms. NB referral size is 5 cm in women. NBT Pre-operative Elective AAA Care Pathway. Safety Checklist on ICE. Surveillance. Amber/ green.

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NBT Pre-operative Elective AAA Care Pathway

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  1. Community referral/screen detected AAA Within hospital referral AAA AAA -give leaflet No AAA OPD Discharge <5.5cm >5.5cm/ symptoms NB referral size is 5 cm in women NBT Pre-operative Elective AAA Care Pathway Safety Checklist on ICE Surveillance Amber/ green Amber/ red CPEX Anaesthetic/ specialist referral CT angio Risks modified MDT Review Book for intervention Fit Unfit Not for elective intervention Book for intervention Unfit Proceed at risk Discharge

  2. Patient Information Leaflets OPD AAA Give info sheet to pt New AAA leaflets currently being printed in NBT & will be available soon. <5.5cm >5.5cm/ symptoms NB. Recovery leaflet can be given at consultation when type of repair is chosen so patient can prepare for recovery or alternatively given upon discharge. ‘Suveillance of AAAs’ leaflet ‘Treatment of AAAs’ leaflet Pre-op Consultation Discharge ‘Recovery from AAAs (OPEN/EVAR)’ leaflet ‘Recovery from AAAs (OPEN/EVAR)’ leaflet

  3. Out-patient pathway for AAA Patient seen by Clinical team Large/symptomatic AAA Safe for surgery checklist/info sheet Small AAA, not For intervention For intervention Not for intervention/ patient declines Book for surveillance Give small AAA info sheet Bloods, FBC, U&E albumin Copy of letter and checklist to MDT Co-ordinator Refer as indicated by pathway

  4. Action Plan

  5. NBT Care Bundle Audit Cycle Action Plan Audit AAA Pre-Operative Care Bundle • Learn from cancer MDT • Safety checklist in Outpatients • Anaesthetist in MDT • Patient list circulated before meeting • Safety checklist • 2.Anaesthetic review • 3. CT angio • 4. Patient information. • Safety checklist (71%) • Anaesthetist (71%) • CT angio (100%)

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