P077 Improving and sustaining compliance with the prep, stop, block protocol in regional anaesthesia: a reflective quality improvement approach to enhance patient safety

<h3>Background and Aims</h3> Wrong-site regional anaesthesia is a rare but preventable adverse event. The prep stop block protocol was introduced to improve patient safety by standardising pre-procedure checks. Despite previous improvements in compliance, sustaining adherence remains a challenge in busy clinical settings. The aim of this project was to support long-term compliance with the protocol to enhance patient safety, and the specific objective was to raise compliance above 75%. <h3>Methods</h3> A quality improvement project using a Plan-Do-Study-Act (PDSA) approach was conducted in a large teaching hospital to address declining compliance with the prep, stop, block protocol. Following an earlier project that raised compliance from 40% to 88%, a re-audit revealed a reduction to 23%. A new approach was taken to promote sustainability of practice by directly engaging anaesthetists. This included structured educational sessions, presentation and discussion at departmental Grand Rounds, and the distribution of surveys. These surveys prompted reflection on barriers to protocol use and gathered feedback on how the protocol could be better integrated into daily practice. A follow-up audit was conducted to assess the impact of these interventions. <h3>Results</h3> Compliance with the protocol increased from 23% to 80% post-intervention. Survey responses indicated improved awareness and engagement, while also highlighting persistent obstacles such as time pressure, lack of reminders, staff turnover and protocol fatigue. <h3>Conclusions</h3> This project demonstrates that sustainable improvements in safety protocol adherence can be achieved through reflective engagement and structured discussion. Rather than relying solely on didactic teaching, prompting clinicians to explore their own barriers and solutions was effective in creating a sense of ownership. Future efforts will focus on embedding the protocol into routine workflows via electronic prompts and ongoing audit cycles.