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

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. Contained in NICE audit support for Acute upper gastrointestinal bleeding: initial management (NICE clinical guideline 141).

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 service providers, healthcare practitioners, and commissioners

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.

What the quality statement means for patients, service users and carers

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: management (NICE clinical guideline 141), 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.