This is a clinical audit presentation which evaluated the usage of PEFR in asthmatic patients presenting to the Accident & Emergency Division of the University Hospital Of West Indies.

1. THE USE OF
PEFR IN
ASTHMATICS AT
UHWI, A CLINICAL
AUDIT
Presented 23.02.16
By : Camille Rainford
Gillian Bent
Yoleigh Gardener
Peter Soltau

2. Introduction

3. The Audit
■ For the purposes of improving patient care, enhance staff professionalism,
increase resource utilization, aid continuing education, and demonstrate
accountability of the quality of clinical services, an asthma protocol was created
and distributed to the staff members of the EMD
■ This Asthma protocol was last updated in 2011
■ The Asthma peak flow audit is a standard based audit

4. ■ Based on the UHWI A&EAsthma Protocol 2011 peak expiratory flow measurements is
one of the two components used in the evaluation of severity of an acute exacerbation

5. ■ This measure is also used to aid in decision making regarding the disposition of
patients who present with an exacerbation of asthma

6. Methodology
■ Log books located inA/E & Casualty was reviewed for all patients with a diagnosis of
asthma
■ The docket numbers were collected and requested from the docket library
■ Dockets were reviewed for documented evidence of ;
– Peak flow request
– Peak flow done (Pre-treatment/Post-treatment)
■ Data collected and analyzed using Microsoft Excel 2013

7. Results
■ Over the study period of 2 months ( October – November 2105 ), a total of 152
asthmatics presented to the EMD UHWI for treatment of exacerbations of bronchial
asthma
■ Of 152 dockets requested :
– 104 were obtained (62.8%)
– 13 contained no asthma notes (0.08%)
– 91 were reviewed (59.8%)
– Of the 91 reviewed (3 were omitted – 1 resolved, 2 peak flow not required age < 3)
– Leaving 88 patients (57.9%) to be audited

8. 0
10
20
30
40
50
60
70
80
90
100
Dockets Not Found
No Asthma Data In Docket
Dockets Reviewed
48
13
91
Total Number Of Patients
Dockets Not Found No Asthma Data In Docket Dockets Reviewed

9. 65%
35%
% Peak Flow Requested
Peak Flow Requested
Peak Flow Not Requested

10. 64%
36%
Pre-Treatment Peak Flow Documentation %
Pre-Treatment Peak Flow Done
Pre-Treatment Peak Flow Not Done

11. 81%
19%
Post-Treatment Peak Flow Documentation %
Post-Treatment Peak Flow Done
Post-Treatment Peak Flow Not Done

12. 99.03%
Expected Peak Flow Documented
Expected Peak Flow Documented Expected Peak Flow Not Documented

13. Limitations
■ Inability to locate dockets (31%)
■ Patient unable to perform peak flow at time of presentation
■ Small sample size
■ No documentation indicating reason for no peak flow being done in
majority of cases

14. Recommendations
■ Emergency AsthmaTreatment Charts
■ Peak Flow Charts
■ Asthma Education (Monday/Wednesday meetings)
■ AsthmaTraining

15. Conclusion
■ Adherence to the asthma policy needs improvement by all
members of staff
■ Continued asthma education and training is needed to improve
adherence

16. ThankYou

17. ■ Of the 88 patients audited:
– 58 patients had a peak flow requested by the attending physician (65%)
– 57 patients had a pre treatment peak flow documented (64%)
– 72 patients had a post treatment peak flow documented (81%)
– 7 patients had a expected peak flow documented (0.07%)