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Bells Palsy management Re-audit
EP31507
Poster Title: Bells Palsy management Re-audit
Submitted on 16 Apr 2020
Author(s): Waqas Jamil
Affiliations: Singleton Hospital
This poster was presented at BACO, MIO
Poster Views: 164
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Poster Information
Abstract: Introduction:
• Bell’s palsy = idiopathic lower motor neuron facial palsy
• The most common cause of acute facial nerve paralysis (>80%)
• Diagnosis of exclusion
• Generally good prognosis
• Significant psychological impact
• Risk of permanent corneal damage

Aims/Objectives:
• Is Bell’s palsy being treated in accordance with The Trust guidelines in Primary Care?
• Any improvement in primary care management since previous audit recommendations sent to GPs.
• Does the ENT Department change GPs management?

Method:
• Retrospective data collection for audit in April-September 2010.Recommendations sent to GP by letter. Re-audit completed collecting data from September-November 2013.
• 30 Bell’s Palsy cases
• 18 sets of data available for analysis
• GPs management commenced was recorded
• Any changes to the management made by ENT were recorded

Results:
• Steroids: 2% more patients received prednisolone at the correct time after the onset of symptoms. 6% more patients received a correct dose of steroids.
• Eye Care: Overall improvement in eye care seen. 53%, 31% and 17% improvement seen in providing eye patch, lacrilube and viscotears respectively.
Conclusions:
Re-audit showed significant improvement in Primary care. In 19% of cases, the ENT department changed GPs management, as compared to 50% cases previously, improvement seen in all areas of eye care. Departmental protocol updated in accordance with recent NICE guidelines. The major emphasis is on eye care management, steroids are given within three days of onset of palsy and antivirals are not recommended anymore.
Summary: A two-cycle clinical audit about management of Bells Palsy.References: Browning G.; Bell’s palsy: a review of three systematic reviews of steroid and anti-viral therapy; Clinical Otolaryngology; 2010; 35, 56–58

De Almeida J.R.; Combined Corticosteroid and Antiviral Treatment for Bell Palsy. A Systematic Review and Meta-analysis; Journal of the American Medical Association; 2009; 302(9)

Jeffrey T.; Bell’s palsy and pregnancy; Otolaryngology–Head and Neck Surgery; 2007; 137, 858-861
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