Vitamin D monitoring and management in the inpatient services – reaudit

Abstract

Aims To survey the prevalence of monitoring of vitamin D on an inpatient ward. To audit the treatment if there is identified vitamin D deficiency or insufficiency To compare differences between findings in audits Method All inpatients admitted to Milford centre between August 2019 and August 2020 were selected as part of the sample size. Data were collected by FY1 and FY2 Patients’ laboratory results were accessed to determine vitamin D levels. E-notes were used to conclude who were vitamin D sufficient or deficient for treatment The standard for the audit were as per: Management of vitamin D deficiency or insufficiency in adults – CKS (2018) The above was based on National Osteoporosis Society (NOS) guideline Vitamin D and bone health: a practical clinical guideline for patient management [National Osteoporosis Society, 2013] and Scientific Advisory Committee on Nutrition (SACN) guideline Result 2017 48/188 patients had vitamin D levels measured 36/48 patients had sufficient vitamin D levels 12/48 patients were either deficient or insufficient 12/12 patients were treated where found deficient or insufficient 2020 90/115 patients had vitamin D levels measured 47/90 patients had sufficient vitamin D Levels 43/90 patients had either insufficient or deficient vitamin D levels 22/43 patients had treatment documented in noted where found deficient or insufficient Conclusion Difficult to make comparisons with previous audit due to difference in number of patients tested Vitamin D is routinely tested on Milford ward on admission hence the large number compared to the last audit 52% had noted to have sufficient levels of vitamin D Concerning were results that only 51% of those deemed to have insufficient or deficient were treated based on notes Potential reasons could be: Prescribed in medication card and not documented in notes. Vitamin D results checked in another ward, no supplementation given, and then transferred to Milford house. Patients refused treatment but not documented adequately. Patient discharged before results were received due to quick around Results were deemed insufficient in terms of the range but very close to normal hence decision made not to start supplementation Results to be disseminated with medical and nursing colleagues Re-audit in September 2021