877 Improving Daily Inpatient Neck of Femur Fracture (NOFF) Patient Care Using a Focused Review Proforma

Abstract

Aim The National Hip Fracture Database (NHFD) encompasses key parameters to reduce mortality and improve care in NOFF patients. Current practice across the NHS incorporates several different inpatient orthogeriatric models. Our quality improvement project sought to improve inpatient care delivered by orthopaedic staff with a geriatric targeted focus. Method An initial audit on 50 patients was conducted and key areas of concern were highlighted. A focussed proforma for daily reviews was implemented which encompassed local and national (NHFD) recommendations and this was re audited for a further 50 patients. Results Documentation of demographics, comoribidites and pre-operative social parameters improved from 70 to 100%. Examination of general health systems improved from 80 to 100%. Identification of nutritional abnormalities improved from 66 to 95%. Documentation of skin condition including wound care and pressure ulcers improved from 55 to 90%. Management of perioperative indwelling urinary catheters improved from 55 to 90%. Identification of unwell patients and thromboembolic risk assessments improved from 65 and 70 to 90 and 95% respectively. Conclusions Our targeted focused proforma facilitated an easy and comprehensive daily review for vulnernable geriatric patients. Additionally, it formed a basis for daily handover amongst juniors changing wards and was adopted formally and adapted for other geriatric services.