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Pleural Procedure LocSSIP Checklist Documentation Audit

Clinical audit of LocSSIP compliance in pleural procedures. Analyzes documentation rates for consent, site marking, and coagulation checks to improve safety.

#clinical-audit#locssip#pleural-procedures#medical-safety#patient-safety#nhs-standards#bts-guidelines
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Clinical Audit

Pleural Procedures Documentation Audit

Compliance with the LocSSIP Checklist

Presented to Medical Consultants | April 2026
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Understanding the Audit

Background & Context

What is LocSSIP?

Local Safety Standards for Invasive Procedures, an NHS-mandated safety protocol based on NatSSIPs.

Designed to explicitly prevent wrong-site and wrong-procedure clinical errors.

Why Pleural Procedures?

Pleural interventions (aspiration, chest drain, thoracoscopy) carry significant risk: pneumothorax, haemorrhage, infection.

BTS guidelines mandate strictly structured pre, peri, and post-procedure documentation.

Why This Audit?

Ensure our local department meets the current, rigorous NHS safety standards.

Identify critical documentation gaps and subsequently drive sustained clinical improvement.

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Clinical Audit

Audit Objectives & Methodology

Objectives

Assess compliance with LocSSIP checklist documentation across pleural procedures

Identify specific steps most frequently missed

Compare performance against BTS/NatSSIP standards

Provide actionable recommendations

Methodology

Retrospective case note review

Inclusion: All pleural procedures performed over a defined audit period

Data collected against each LocSSIP phase: pre-procedure, intra-procedure, post-procedure

Standards: BTS Pleural Disease Guidelines & local LocSSIP policy

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Clinical Audit

Audit Data & Results

Total Procedures Reviewed
47
Overall Checklist Completion
73%
Checklist Item
Compliance
Patient ID confirmed
95%
Consent documented
78%
Site marked / laterality confirmed
82%
Ultrasound performed & documented
70%
Coagulation / anticoagulation checked
58%
Post-procedure plan documented
65%
Specimen labelling
88%
Equipment check
72%
≥ 80% (Pass)
60% – 79% (Review)
< 60% (Action Required)
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Clinical Audit Review

Key Findings

Summary of the most critical observations and compliance rates from the LocSSIP checklist audit.

1

Coagulation checks most frequently missed

Only 58% compliance, posing a significant procedural bleeding risk

58%
2

Post-procedure documentation inconsistent

65% compliance, frequently missing documented follow-up management plans

65%
3

Ultrasound documentation gaps

70% compliance despite BTS mandating pre-procedure USS

70%
4

Consent documentation improving but not complete

22% of analysed cases proceeded without formally documented patient consent

78%
5

No serious adverse events recorded

Patient safety maintained with only 2 minor complications (pneumothorax) in the period

0
SAEs
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Action Plan

Recommendations

Standard Target

≥95% compliance with all LocSSIP checklist items (BTS/NatSSIPs)

1

Mandatory Checklist Use

Enforce LocSSIP checklist use for ALL pleural procedures via departmental policy.

2

Targeted Training

Targeted training on coagulation/anticoagulation assessment before procedures.

3

Standardise Documentation

Implement a standard post-procedure documentation template in clinical notes.

4

Embed Ultrasound Details

Integrate required ultrasound documentation directly into the procedure proforma.

5

6-Month Re-audit

Perform a follow-up clinical audit in 6 months to assess compliance improvement.

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Thank You

Questions & Discussion

For further information, contact the Clinical Audit Team
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Pleural Procedure LocSSIP Checklist Documentation Audit

Clinical audit of LocSSIP compliance in pleural procedures. Analyzes documentation rates for consent, site marking, and coagulation checks to improve safety.

Pleural Procedures Documentation Audit

Compliance with the LocSSIP Checklist

Presented to Medical Consultants | April 2026

Background & Context

Understanding the Audit

What is LocSSIP?

Local Safety Standards for Invasive Procedures, an NHS-mandated safety protocol based on NatSSIPs.

Designed to explicitly prevent wrong-site and wrong-procedure clinical errors.

Why Pleural Procedures?

Pleural interventions (aspiration, chest drain, thoracoscopy) carry significant risk: pneumothorax, haemorrhage, infection.

BTS guidelines mandate strictly structured pre, peri, and post-procedure documentation.

Why This Audit?

Ensure our local department meets the current, rigorous NHS safety standards.

Identify critical documentation gaps and subsequently drive sustained clinical improvement.

Audit Objectives & Methodology

Assess compliance with LocSSIP checklist documentation across pleural procedures

Identify specific steps most frequently missed

Compare performance against BTS/NatSSIP standards

Provide actionable recommendations

Retrospective case note review

All pleural procedures performed over a defined audit period

Data collected against each LocSSIP phase: pre-procedure, intra-procedure, post-procedure

BTS Pleural Disease Guidelines & local LocSSIP policy

Audit Data & Results

Total Procedures Reviewed

47

Overall Checklist Completion

73%

Patient ID confirmed

95%

Consent documented

78%

Site marked / laterality confirmed

82%

Ultrasound performed & documented

70%

Coagulation / anticoagulation checked

58%

Post-procedure plan documented

65%

Specimen labelling

88%

Equipment check

72%

Clinical Audit Review

Key Findings

Summary of the most critical observations and compliance rates from the LocSSIP checklist audit.

Coagulation checks most frequently missed

Only 58% compliance, posing a significant procedural bleeding risk

58%

Post-procedure documentation inconsistent

65% compliance, frequently missing documented follow-up management plans

65%

Ultrasound documentation gaps

70% compliance despite BTS mandating pre-procedure USS

70%

Consent documentation improving but not complete

22% of analysed cases proceeded without formally documented patient consent

78%

No serious adverse events recorded

Patient safety maintained with only 2 minor complications (pneumothorax) in the period

0

Recommendations

Standard Target

≥95% compliance with all LocSSIP checklist items (BTS/NatSSIPs)

1

Mandatory Checklist Use

Enforce LocSSIP checklist use for ALL pleural procedures via departmental policy.

2

Targeted Training

Targeted training on coagulation/anticoagulation assessment before procedures.

3

Standardise Documentation

Implement a standard post-procedure documentation template in clinical notes.

4

Embed Ultrasound Details

Integrate required ultrasound documentation directly into the procedure proforma.

5

6-Month Re-audit

Perform a follow-up clinical audit in 6 months to assess compliance improvement.

Thank You

Questions & Discussion

For further information, contact the Clinical Audit Team

  • clinical-audit
  • locssip
  • pleural-procedures
  • medical-safety
  • patient-safety
  • nhs-standards
  • bts-guidelines