Work

Zeroing in: achieving zero complications in lumbar puncture – a quality improvement initiative to reduce complications at the University Hospital of North Norway

Year: 2025

Type: article

Abstract: BACKGROUND: Lumbar puncture (LP) is an essential diagnostic procedure in neurology, but carries risk, with post-lumbar puncture headache being the most frequent complication. In 2017, a severe complication with intracranial haemorrhage following LP in Northern Norway led to an evaluation of LP procedures and resulted in the development of a new unified regional procedure. LOCAL PROBLEM: At the University Hospital of North Norway (UNN), 10% of LPs performed in 2017 resulted in a complication. A survey identified gaps in protocol adherence, physician training, and patient education. INTERVENTION: Aiming to reduce LP complication rates from 10% to 1% by January 2019, we implemented standardised protocols, introduced smaller gauge needles, enhanced physician training and improved patient education. RESULTS: Complication rates dropped to 1%, achieving 107 consecutive complication-free procedures by January 2019, with sustained improvement over subsequent years. CONCLUSION: Standardised protocols, physician training, introduction of smaller gauge needles and patient education significantly reduced LP complications. Educating patients on expectations and post-procedure care was critical in preventing unnecessary admissions and outpatient visits.

Source: BMJ Open Quality

DOI: 10.1136/bmjoq-2025-003327

Authors: Susanne Gaarden Ingebrigtsen, Agnethe Eltoft, Thomas Karsten Kilvaer

Institutions: University Hospital of North Norway, UiT The Arctic University of Norway

Language: English

Topic: Healthcare Quality and Management

Subfield: Health Information Management

Field: Health Professions

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,839