Vusumuzi Sibanda
William Harvey Hospital, United KingdomTitle: Quality of management and documentation of paediatric supracondylar fractures: A closed loop audit
Abstract
Aim
Supracondylar fractures are the most common elbow fractures in children. It is important that their documentation and management is done fully and correctly. This audit aimed at assessing the quality of management and documentation according to British Orthopaedic Association Standards (BOAST) guidelines for supracondylar fractures, implement recommendations then reassess compliance as a second loop audit.
Methods
Data was obtained for patients who were treated for paediatric supracondylar fractures from January 2018 – November 2020. Data analysed included fracture type, documentation of neurovascular status pre and post intervention, management, as well as outcomes. After the first cycle, findings were presented in our audit meeting and recommendations were implemented including formulation of a documentation proforma. Second Cycle: Data was derived from the same records for patients treated from April-October 2021.
Results
The first cycle had 48patients versus 26 in the second. Mean age was 6.4 and 6.5years respectively. 42 out of the 48 in the first cycle and all 26 in the second required operative management. Only 39% of patients had full documentation of neurovascular status pre-reduction and this dropped to 19% in the second cycle, while 44% and 69% were documented as “neurovascular intact” (NVI) and 17% and 12% respectively had no documentation at all. With regards to post-op documentation in the first cycle, 38% had full documentation, 7% were documented as NVI, 56% had no documentation compared to 38%, 35% and 27% respectively in the re-audit.
Conclusion
Our local management and follow-up of supracondylar fractures is in keeping with BOAST Standards however the quality of documentation falls below the standards. Going forward, proformas/templates should be made available online to ensure documentation is done on presentation to A&E and throughout the patient’s admission. There is also a need to educate clinicians on the importance of documentation.
Biography
Vusumuzi Sibanda is a Trauma and Orthopaedic registrar at the William Harvey Hospital in the East Kent Hospitals University NHS Foundation Trust. He is a keen researcher and is interested in trauma and spine surgery as a subspecialty.
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