Development of Local Pathways for Follow-up of Suspected Perioperative Anaphylaxis

Abstract

Aims
This project aimed to enhance staff awareness, documentation, and follow-up of suspected perioperative anaphylaxis through the implementation of guidelines and education.

Methods
The first intervention involved the development of local anaphylaxis investigation guidelines. An anaphylaxis investigation pack was also created. This included a referral form and template letters for patients and their general practitioners. To prevent loss to follow-up, a new local follow-up pathway was established. This pathway included a dual referral process; patients were referred both to the immunology centre and to our local anaesthesia clinic. A departmental education session was provided. Staff surveys were conducted pre- and post-intervention.

Results
Referral form location awareness improved from 3/14 (21%) to 6/16 (37.5%). Awareness of mast cell tryptase testing remained high (14/14 [100%] pre- vs 15/16 [93.75%] post-intervention), with improved knowledge of correct sampling timing (10/14 [71%] to 13/16 [81.25%]). However, recognition of the correct sample tube colour remained low (3/14 [21%] to 4/16 [25%]), and understanding of required referral documents decreased (2/14 [14%] to 1/16 [6.25%]).

Discussion
This project highlights the challenges in maintaining staff awareness of the referral process. While targeted interventions improved knowledge in specific areas, overall retention of key details was limited. Ensuring clear, accessible guidelines and implementing a reliable follow-up system are essential to safeguarding referrals.