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Q Bulletin, Volume 1, No. 32 (Supplement 1), Jan - Dec 202412th National QA Convention, 8 %u2013 10 October 2024QLL-74Clinical Audit on Cancellation of Elective Daycare Tenckhoff Catheter InsertionSurgery on a Scheduled Day in Hospital Tengku Ampuan RahimahFairuz M, Norleen ZS, Foo GT, Azian M, Norlaila AHospital Tengku Ampuan Rahimah, SelangorINTRODUCTION:Peritoneal Dialysis (PD) is one of the three modes of kidney replacement therapy. Tenckhoff catheter(TC) insertion is required at least 2 weeks prior to commencing PD training. The cancellation of electivesurgery has significant ramifications for both healthcare professionals and patients. It leads to extendedwaiting times, heightened costs, and imposes physical and psychological distress on the patients. Ourdepartment introduced elective daycare TC insertion in 2022. To identify and analyse the causes or factorscontributing to the cancellation of elective TC insertion and to reduce the cancellation of elective surgeryunder our daycare.METHODOLOGY:This was a prospective audit. The first cycle was between 1st January and 31st March 2023. Pre-operativeassessment was done 5 days and 1 day prior to elective surgery. Action plans implemented after review ofthe first cycle were early identification of patients with transportation issue (for admission one day prior)during assessment, and a call one week prior to the 5 days pre-operative assessment. The second cyclewas between 1st May and 31st August 2023.RESULTS:The first cycle had 44 cases. 16% (7 cases) were cancelled. 11% (five cases) were preventable: oneuncontrolled hypertension, one failed to disclose recent contact with carbapenem-resistant enterococcus(CRE) and 3 refused surgeries. 5% (two cases) were non-preventable: infection on the day of operationand uncontrolled bleeding during surgery. The second cycle had 52 cases. 11.5 % (six cases) werecancelled. 9% (five cases) were preventable: one refused surgery, two had fluid overload, one was failureto detect thrombocytopenia and one was presumed Tenckhoff malfunction without proper assessment. 2%(one case) was non-preventable: patient labelled as CRE contact a day prior to surgery.DISCUSSION:Remedial actions significantly reduced TC insertion cancellation rate from 16% to 11.5%. Conducting athorough pre-operative evaluation is of utmost importance.172 | Page