Audit tool to assess compliance with current infective endocarditis service delivery guidelines
| Audit tool | Compliant |
| 4.1 Endocarditis teams | |
| Hospital is involved in the care of patients with confirmed or suspected IE and has an IE team. | y/n/na |
| IE team includes an infection specialist. | y/n |
| IE team includes a cardiologist. | y/n |
| IE team includes an accredited specialist in echocardiography. | y/n/na |
| At heart centres, the IE team includes a cardiac surgeon. | y/n |
| At heart centres, the IE team includes a cardiologist with expertise in adult congenital heart disease. | y/n/na |
| At heart centres, the IE team includes cardiologists with expertise in the removal of infected implantable cardiac electronic devices. | y/n |
| Local guidelines for the diagnosis, investigation, and the empirical and directed antibiotic therapy of suspected/confirmed IE | y/n |
| Weekly IE team review of patients with confirmed or suspected IE (MDT meeting and/or bedside patient review, over and above daily clinical review) | y/n |
| 4.2 Endocarditis service infrastructure and support | |
| IE team in referring centres can transfer patients to a heart centre 24 hours a day 7 days a week | y/n/na |
| Operating schedules allow for urgent or emergency surgery in patients with IE | y/n/na |
IE team at the heart centre has access to specialist advice:
| y/n y/n y/n y/n y/n y/n |
IE team has access to on-site
IE team has timely access (within a week) to
| y/n y/n y/n y/n y/n y/n |
| Substance misuse teams are available to support people who inject drugs and have IE | y/n |
| 4.3 Endocarditis referral processes | |
| All patients with IE at a referring hospital discussed with the IE team at a heart centre to allow decisions regarding treatment and transfer | % compliance/na |
| Cardiac imaging from all patients included in discussions with IE team at heart centre | % compliance/na |
| All patients with IE at referring hospitals with ‘red flags’ (box 2) transferred to a heart centre | % compliance/na |
| Clear point of contact for the IE team (including a dedicated phone line or email address) | y/n |
| System of alerts based on clinical, microbiological or echocardiographic findings that trigger referral to the IE team | y/n |
| Communication system for referral of new patients to/between IE teams in place | y/n |
| Patients with IE transferred between hospitals accompanied by records detailing their | |
| Clinical presentation | % compliance |
| Medical/cardiac history | % compliance |
| Medications | % compliance |
| Allergies | % compliance |
| Microbiological findings | % compliance |
| Imaging findings | % compliance |
| Details of all recent antibiotic therapy (including start/stop dates, doses, frequency and route of administration) | % compliance |
| Vascular access device(s) details (presence and insertion date) | % compliance |
| 4.4 Patient follow-up and patient information | |
| All patients being treated for IE offered written information about the condition. | % compliance |
| All patients who are discharged following treatment for IE advised of the risk of relapse and recurrence, and how to recognise the symptoms of IE. | % compliance |
| All patients advised to inform their GP that they have had IE and discuss the need for blood cultures if they have a persistent non-specific feverish illness. | % compliance |
| All patients with IE offered follow-up in a valve or general cardiology clinic. | % compliance |
GP, general practitioner; IE, infective endocarditis; n, no; na, not applicable; y, yes.