Quality standard

Quality statement 3: Endoscopy within 24 hours for people who are haemodynamically stable

Quality statement

People admitted to hospital with acute upper gastrointestinal bleeding who are haemodynamically stable are given an endoscopy within 24 hours of admission.

Rationale

In most cases, endoscopy diagnoses the cause of bleeding, provides information about the likely prognosis and facilitates delivery of a range of haemostatic therapies. People admitted to hospital who are haemodynamically stable should be given an endoscopy within 24 hours of admission. This will help to avoid re-bleeding, and can reduce the length of their hospital stay.

Quality measures

The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured, and can be adapted and used flexibly.

Structure

Evidence of local arrangements to ensure that people admitted to hospital with acute upper gastrointestinal bleeding who are haemodynamically stable are given an endoscopy within 24 hours of admission.

Data source: Local data collection.

Process

Proportion of people admitted to hospital with acute upper gastrointestinal bleeding who are haemodynamically stable who receive endoscopy within 24 hours of admission.

Numerator – the number of people in the denominator who receive endoscopy within 24 hours of admission.

Denominator – the number of people admitted to hospital with acute upper gastrointestinal bleeding who are haemodynamically stable.

Data source: Local data collection.

Outcome

Length of hospital stay for people with acute upper gastrointestinal bleeding who are haemodynamically stable.

Data source: Local data collection.

What the quality statement means for different audiences

Service providers ensure that systems are in place for people admitted to hospital with acute upper gastrointestinal bleeding who are haemodynamically stable to be given an endoscopy within 24 hours of admission.

Healthcare practitioners perform endoscopy within 24 hours of hospital admission in people with acute upper gastrointestinal bleeding who are haemodynamically stable.

Commissioners ensure that they commission services that give an endoscopy within 24 hours of hospital admission to people with acute upper gastrointestinal bleeding who are haemodynamically stable.

People with acute upper gastrointestinal bleeding whose blood pressure and pulse are stable and who are admitted to hospital are given an endoscopy (a procedure using a narrow, flexible tube that is swallowed and has a very small camera at its tip) within 24 hours of admission.

Source guidance

Acute upper gastrointestinal bleeding in over 16s: management. NICE guideline CG141 (2012, updated 2016), recommendation 1.3.2 (key priority for implementation)

Definitions of terms used in this quality statement

Haemodynamically stable

People who are haemodynamically stable have stabilised blood pressure and pulse.