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Upper Gastrointestinal Bleed Audit (PPI in AUGIB)

Audit is a mandatory, and important, part of postgraduate training but many audits do not capture sufficient data to drive service change. The audit cycle can be broken when doctors in training rotate away from institutions. Our aim was to demonstrate the feasibility of a multi-centre audit delivered through the GARNet. 

We audited national guidance NICE CG141, updated August 2016, stating that patients with suspected acute upper gastrointestinal bleeding (AUGIB) should not be offered acid suppression drugs prior to endoscopy.


This was a prospective audit in 9 hospitals in the East Midlands, UK. Patients: aged ≥16 years, admitted in November 2016 with suspected AUGIB who underwent inpatient endoscopy. Current inpatients who developed UGIB were excluded. Each hospital registered with its audit department. Anonymised data were pooled for analysis.  


Standard for primary endpoint: 0% should receive acid suppression.

Standards for secondary endpoints: 100% of patients should be offered endoscopy within 24 hours of admission. Data on other aspects of CG141 were also collected.


1st cycle complete, in quality improvement phase "to increase the proportion of patients with AUGIB who undergo OGD within 24 hours of presentation"


  • November 2016 - launch of the GARNet and 1st audit cycle

  • 26/01/17 - regional results presented

  • 01/03/17 - agreed regional quality improvement objective "to increase the proportion of patients with AUGIB who undergo OGD within 24 hours of presentation"

  • 24/04/17 - feedback quality improvement ideas (local priorities, QIP plans), potential barriers, agree plan

  • by end April 2017 - finalise site data, finalise resources to facilitate QIP and local audit presentations

  • 12/05/17 - oral presentation at MGS conference

  • 23/05/17 - update from study sites on progress with QIP

  • June 2017 - poster presentation at BSG conference

  • by end of Q2 2017 - finalise and implement locally-tailored quality improvements

  • 06/07/17 - update from study sites, finalise plan for re-audit

  • Q3 2017 - 2nd audit cycle (one month period with modified pro-forma)

  • Q4 2017 - discuss results and future plans, submit for publication


Complete information to follow shortly

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