TY - JOUR
AR - JICOA-2020-5-110
TI - An Audit on "Atrial Fibrillation & Anti-Coagulation" at University Hospitals of North Midlands NHS Trust (2015-2017)
AU - M.I.A, Qureshi 
AU - Anil , Kumar
AU - Anil K , Miryala
JO - Journal of Integrative Cardiology Open Access
PY - 2020
DA - Tue 10, Nov 2020
SN - 2674-2489
DO - http://dx.doi.org/10.31487/j.JICOA.2020.05.10
UR - https://www.sciencerepository.org/an-audit-on-atrial-fibrillation-anti-coagulation-at-university_JICOA-2020-5-110 
KW -  Atrial fibrillation, anti-coagulation, documentation, patient safety
AB - Background: During hospital admission, it was noticed that most patients with atrial fibrillation (new or
old) diagnosis have no clear documented plan about anticoagulation. It was considered a significant risk for
patient safety.
Aim: To determine whether patients with atrial fibrillation diagnosis were on anticoagulation or not, if not
have the reasons been documented in the medical notes. If new-onset atrial fibrillation whether CHADSVASC and HASBLED scores have been used or not for anticoagulation purpose.
Settings: County Hospital Stafford & Royal Stoke University Hospital (UHNM 2015-2017).
Materials and Methods: Prospective audit, a total of 100 patient's data (50 patients per cycle) were
analysed by using specific audit Performa based upon NICE Atrial Fibrillation 2014 Guidelines [1].
Statistical Analysis: Data was coded, entered in an excel spreadsheet and analysed by translating into
percentages and proportions.
Results: Initial audit showed that out of 50 patients with atrial fibrillation diagnosis, 30 were already on
anticoagulation and 20 were not on anticoagulation. Only 2 out of 20 were assessed for anticoagulation and
18 were not assessed. AF Performa was introduced in the clerking sheet post initial audit. Re-audit after 6
months showed 43 out of 50 patients were on anticoagulation and 7 were not. Out of these 7 patients, 3
patients had absolute contraindications (Subdural Haematoma, Rectal bleeding and major haematoma), 2
patients were assessed for anticoagulation however were not followed up and 2 were not assessed. Results
comparison is explained in (Table 1).
Conclusions: This audit has demonstrated significant improvement in overall anticoagulation rates in
suitable patients which have helped in improving patient safety.