Protocol-based guidelines and acute upper gastrointestinal hemorrhage

hemorrhageMost audits of acute upper gastrointestinal (GI) hemorrhage usually involve an initial retrospective study to determine the management and outcome, followed by a prospective analysis that attempts to ascertain the impact of specific alteration in clinical practice, making comparison complex and unreliable. A prospective audit was started at Frimley Park Hospital (FPH), United Kingdom, in January 2000.

The purpose of the audit is:

•    To establish the current practice and outcome of upper GI hemorrhage in FPH.

•    To introduce protocol, educate and train the health care professionals involved.

•    Assess the impact of protocol on practice and outcome.

The first phase of the audit to assess the management and outcome of upper GI hemorrhage was completed in April 2000. An agreed protocol on the management of patients with upper GI hemorrhage at FPH was drawn up in light of the findings of the first phase of the audit. The health care professionals involved with care of such patients had been instructed and informed of the protocol. The protocol involved management guidelines for patients with upper GI hemorrhage. Any change in practice and outcome following the introduction of the protocol was monitored through the second phase of the prospective audit, which was completed in September 2000.
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