498 Junior Doctor Checklist for the Management of Neck of Femur Fracture: A Quality Improvement Project

Abstract Aim Patients admitted with Neck of Femur (NOF) fracture are often complex and frail. Junior doctors in our institution first on call have minimal orthopaedic experience. Anecdotal experience has shown that patients inadequately optimised. For example, fluids not prescribed, anticoagulants reversed which could lead to further complications delay surgery, affecting patient outcomes. Therefore, we developed a junior doctor checklist improve the quality care for NOF fracture. Method A plan-do-study-act (PDSA) methodology was utilized designing this project. Data collected prospectively from 50 presented pre post intervention. Clerking proforma, drug chart electronic systems were reviewed. Outcome measures prescription analgesia, fluids, anti-emetics laxatives, completion venous thromboembolism (VTE) prophylaxis, abbreviated mental test (AMT), group save reversal anticoagulation, if available. Intervention included production outlining management plan distributed doctors. Results Areas improvement identified intervention cycle anti-emetics, anticoagulant reversal, compliance 56%, 44%, 42% 50%. Other parameters had >90% Post 90% 66% 74% laxatives 80% reversal. Conclusion Introduction is effective improving neck femur More interventions incorporating PDSA will be carried out strive improvement.