BLOOD BORNE INFECTION SCREENING AT INITIAL HEALTH ASSESSMENTS FOR LOOKED AFTER CHILDREN IN A DISTRICT HOSPITAL

Abstract

Objectives To improve time scales for blood borne infection (BBI) screening for looked after children after initial health assessment (IHA). Methods Retrospective data collection from IHAs completed over 6 months. Data analysis reviewed time intervals within process from IHA to action of blood tests. This was re-audited after 6 months of implemented changes. Results Initial data collection identified 49 patients with completed IHAs between June-November 2021; 34 with BBI screening recommended, of whom 11 had BBI blood tests completed. Reasons for not having blood tests included: prior antenatal testing, non-attendance, patient/parent refusal, moved out of area, referral to sexual health. Initial data demonstrated significant time between IHA to BBI bloods taken, on average 129.8 days (range 46–230). Analysis identified time from posting consent form to receipt of completed consent via social care as the longest stage: 79 days (10–257). Significant time intervals were also identified between: IHA to consent form posted 22.3 days (6–61). Receipt of consent to bloods taken 47.5 days (8–82). Bloods taken to issue of results letter 23.6 days (3–106). Several interventions were made BBI consent obtained at IHA where possible, local guideline issued outlining indications for BBI screening as per national guidance1 Blood test availability increased, next available allocated instead of partial booking. Doctor informed when blood test completed, prompting timely review of results and issue of standardised results letter. Several interventions were madeReaudit after 6 months identified 53 completed IHAs; 28 with BBI screening recommended, of whom 8 consented in clinic. Of those consented in clinic, 5 had bloods tests, with mean time from IHA to blood test of 28.2 days (range 14–40). For the 20 not consented at IHA, 14 had blood tests; mean time from IHA to bloods taken was 53.1 days (7–79 days). Reasons for not having blood tests remained comparable: return to care of birth parent, non-responders, non-attendance, declining blood test. In summary data from reaudit demonstrates that completing consent at IHA reduced interval between IHA and bloods by 24.9 days. Compared with initial data prior to all interventions a reduction of 101.6 days (78%) from IHA to bloods taken. Conclusion We highlighted lengthy timescales in process of BBI screening recommended from IHA and where these delays occurred. After implementing quality improvement strategies, the most pertinent of which was obtaining consent at IHA, we have demonstrated significant improvement in timescales for BBI screening for looked after children.