IBD inpatient care audit - Adult report - round four 2014

Produced by:

This report examines the inpatient care provided to people admitted to hospitals in the UK for treatment of UC between 1 January 2013 and 31 December 2013. For the first time, a small number of questions also address the outpatient care provided to each patient prior to their admission to hospital.

Key recommendations

  • All outpatients with UC should have their disease activity accurately assessed (eg using symptoms and faecal calprotectin), and treatment should be initiated or escalated in those with active disease. Early intervention may prevent admission.
  • All patients with a new diagnosis of UC, those for whom the use of anti‐TNFα is considered and those requiring additional information should be seen by an IBD nurse during admission.
  • IBD services should ensure that inpatient IBD care provided by the IBD nurse is appropriately resourced in line with IBD Standard A1 (1.5 whole‐time equivalent nurse per 250,000 population).
  • All IBD patients admitted to hospital should be weighed and their nutritional needs assessed, in line with IBD Standard A10.
  • Bone protection should be prescribed to all patients with UC who receive corticosteroids.
  • Heparin should be given to all patients for whom it is not contraindicated, to reduce the risk of thromboembolism.
  • All patients on steroids for longer than 3 months should be considered for steroid‐sparing agents such as azathioprine.
  • Anaemia should be actively investigated, and the cause should be identified and treated appropriately.
  • Further national audit in IBD should be commissioned.