Non visualised scan audit

aaa.screening.nhs.uk National programme website – aaa.screening.nhs.uk

Abdominal Aortic Aneurysm

Five Rivers AAA Screening ProgrammeReview of Non-Visualised Scans

Caroline Wells (Programme Manager)March 2016

http://aaa.screening.nhs.uk/

aaa.screening.nhs.uk

Overview• National guidance• Local and national performance• Review of 2014/15 and 2015/16 data

– By machine– By user– Reasons for non-visualisation

• Conclusions



National guidance• NAAASP requires both TS

and LS aortic measurements for the screening test to be classed as successful

• If any part of the infrarenal aorta cannot be visualised it should be recorded as a non-visualised scan

NAAASP (2014) Non-visualised aortas: Guidance for local AAA screening programmes in the management of non-visualised screening results



National guidance

Reasons for non-visualisation include:•High body mass index•Excessive bowel gas •Ambiguity regarding calliper placement and aortic diameter measurement•Unusual anatomy or pathology



National guidance

NAAASP (2015) Pathway Standards for NHS Abdominal Aortic Aneurysm Screening Programme

Standard 9 •Percentage of screening encounters where aorta could not be visualised

Rationale•A high non-visualised rate may be due to a training issue, equipment maintenance issues or it may be a reflection of the population being screened



Performance

Five Rivers AAA Screening Programme•Increase in the number of non-visualised scans over the last year:

– 0.53% in 2014/15 (21 scans)– 1.16% up to the end of Q3 2015/16 (28 scans)

•Nationally:– 1.41% of scans were non-visualised in 2014/15– 1.39% up to the end of Q3 2015/16

•Thresholds: Acceptable ≤ 3% Achievable ≤ 1%



Number of non-visualised scans by machine(as a percentage of total scans completed per machine)

Sonosite machines in use since April 2012Green and blue systems were replaced in April 2014



Number of non-visualised scans by user(as a percentage of total scans completed per Screening Technician)



Reasons for non-visualisation



Conclusions• No obvious pattern with equipment or user

• It may be possible to minimise the number of non-visualised scans due to bowel gas – Use of techniques such as breathing exercises and

movement to help move the gas– Further analysis of possible causes of bowel gas e.g.

medication


Non visualised scan audit

Healthcare

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