A Quality Improvement Project Focused on Clinical Audit and Re-audit of Anticoagulation Use in Atrial Fibrillation Patients with International Guidelines

Author : Dr Hina Ali Akbar

Abstract :Background: Atrial fibrillation (AF) increases stroke risk, requiring structured risk stratification and appropriate anticoagulation guided by CHA₂DS₂-VA and HAS-BLED scores. This Quality Improvement Project aimed to improve the documentation and application of these tools in an acute care setting, in line with ESC and NICE guidelines. Methods: A retrospective audit of 50 AF patients between March–August 2024 assessed the use of CHA₂DS₂-VA and HAS-BLED scoring and anticoagulation practice. Gaps included low risk score documentation and incorrect anticoagulant dosing. Interventions included staff education, protocol updates, and improved documentation systems. A re-audit of 50 patients was conducted three months later. Results: Baseline data showed CHA₂DS₂-VA and HAS-BLED were calculated in 27% and 5% of cases, respectively; 42% of patients were prescribed anticoagulants, with correct dosing in only 20%. Post intervention, both scores were documented in 100% of cases, anticoagulant prescribing and correct dosing reached 100%, and no eligible patients were left untreated. Minor bleeding was reported, but no major complications occurred. Conclusion: Targeted education and workflow integration of guideline-based tools significantly improved AF risk assessment and anticoagulation practices, enhancing patient safety and standard of care.

Keywords :AF, anticoagulation, CHA₂DS₂-VA, HAS-BLED, QIP, ESC, NICE, audit.

Conference Name :International Conference on Cardiology and Cardiovascular Medicine (ICCCM-25)

Conference Place Lahore, Pakistan's

Conference Date 27th Aug 2025