863 Improving the Outcomes of Inpatient Admissions and Optimising Referrals to a Regional Burns Unit Through Introduction of a Specialist Nurse-Led Burns Clinic

Abstract

Aim We aimed to measure the effect of a specialist nurse-led clinic and referral pathway on admission rate, patient length of stay (LOS), and total bed days. We hypothesised that this intervention would contribute to the optimisation of the patient pathway in a regional burn's unit. Method Retrospective analysis of inpatient records in a six-month period over three years at a regional burn's unit (June-November 2018,2019,2020). Analysis of demographics, TBSA, admissions, and length of stay before and after clinic introduction. Statistical analysis included one-way ANOVA. Results A reduction in admissions was observed in 2020 compared to 2019 and 2018 (7.3% and 6.7%) for a patient group with equivalent median TBSA (2%) and comparable median age (41 vs. 43.5 and 42.5). Median LOS was significantly shortened compared to 2019 (42.9%, F=4.07, p=0.046) and 2018 (42.9%, F=6.59, p=0.011). Minor burns showed reduced admission rates compared to 2019 (8.5%), and reduced median LOS (42.9% and 33.3%), and reduced total bed days (29.4% and 27.1%) compared to 2019 and 2018 respectively. Referrals to the regional burn's unit as a percentage total of regional A&E burns presentations increased in 2020 compared to 2019 and 2018 (16% vs. 14.4% and 12.1%). Conclusions The results suggest that the introduction of a specialist clinic has shortened in-patient stay with a significant effect on minor burns, against a backdrop of increased referrals. We suggest that continuity between clinic and inpatient care by a specialist nursing team has helped to optimise the regional burns unit.