Abstract
Introduction
In the United Kingdom an average of 65,000 patients attend hospital with hip fractures each year, with 87% of these patients over the age of 70. Effective pain management is associated with significantly improved outcomes. Pain is known to be a significant trigger for delirium which itself greatly increases 1 year mortality and morbidity. Given the magnitude of the issue, this audit aimed to assess the effectiveness of an intervention in relation to the NICE National Standards for Neck of Femur (NOF) fractures at Weston General Hospital.
Methods
Data sets were collected from NOF fracture patients attending Weston General Hospital (WGH) Emergency Department (ED). The first data was from 29 patients between 4/4/2022-13/5/2022 and the second from 48 patients between 12/9/2022-22/2/2023. The red phone proforma in ED was amended in-between these data collections to include pain scoring and X-ray. Basic analysis allowed comparison between data sets.
Results
11.11% of patients had pain assessed within 15 minutes of arrival compared to 13.79% previously. For standard 2&3, 8.82% of patients had analgesia within 60 minutes, thus not meeting NICE targets. 93.18% of patients had an x-ray requested within 120 minutes compared to 62.07% previously.
Conclusion
Our results were very positive regarding X-ray time. However, the intervention did not improve pain assessment and analgesia time. Going forward, block training should be increased and more widely available in the ED given that only 33% of patients received one on admission. Additional consideration would be to edit the proforma to include pain re-assessment to closer meet NICE targets and improve patient care.