SHM Converge Scientific Abstract ePoster Gallery-Complications? What Complications: A Method for Tracking and Reviewing Adverse Events Within a Medicine Bedside Procedure Service

Complications? What Complications: A Method for Tracking and Reviewing Adverse Events Within a Medicine Bedside Procedure Service

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This study examined bleeding and other complications after paracentesis performed by a hospital medicine procedure service (MPS) at the University of Minnesota, comparing two ultrasound approaches: static pre-procedure guidance versus real-time (live) guidance.<br /><br />Paracentesis is generally considered a safe procedure, especially when ultrasound is used. The team reviewed 2,651 paracenteses done in 1,095 patients from 2016 to 2022. The service started with static ultrasound guidance and later transitioned to standardized real-time guidance in 2019.<br /><br />Complications were identified using ICD codes and then manually reviewed to confirm whether they were real complications, whether they were actually caused by paracentesis, and whether they were attributable to the MPS. Of 73 flagged complications, 61 (83.6%) were confirmed as valid ICD-coded events. However, only 27 of the 73 flagged events were truly related to paracentesis, and only 12 were attributable to the MPS.<br /><br />Overall complication rates were low: 27 total complications attributable to paracentesis (1.0%) and 12 attributable to the MPS (0.5%). Importantly, there was no meaningful difference in complication rates after switching from static to real-time ultrasound guidance. Real-time guidance did reduce efficiency slightly, with fewer paracenteses performed per admission, but the effect was small.<br /><br />The authors conclude that paracentesis remains a low-risk procedure in a dedicated procedure service. They also found that using ICD codes as a trigger for chart review is a practical way to monitor for complications, since complications can be missed if only relying on direct reporting.

Asset Subtitle

Zachary Kaltenborn

Meta Tag

Author List Katelyn Tessier, Kiril Dimitrov, Nirjhar Dutta, Zachary Kaltenborn

Category Research

Concept Paracentesis

Concept Safety Profile

Concept Complication Rate

Concept Procedure-Related Complication

Concept Hospital Medicine Procedure Service

Distinguished Non-Finalist

Presenter Organization University of Minnesota

Presenting Author Zachary Kaltenborn

Track Patient Safety

Keywords

paracentesis

bleeding complications

ultrasound guidance

static guidance

real-time guidance

hospital medicine procedure service

University of Minnesota

complication rates

ICD codes

procedure safety

Paracentesis

Safety Profile

Complication Rate

Procedure-Related Complication

Hospital Medicine Procedure Service