AB215. 49. An audit of the adherence to the National Institute for Health and Clinical Excellence guidelines on perioperative management times of geriatric hip fractures in Letterkenny University Hospital

Background: The aim of this research was to determine whether the National Institute for Health and Clinical Excellence (NICE) guidelines regarding the timely perioperative management of geriatric hip fractures are being achieved within Letterkenny University Hospital (LUH).

Methods: This research investigated whether the multidisciplinary approach to geriatric hip fractures is resulting in a timeous management protocol. An audit of patients discharged between January 1, 2017 and October 9, 2017 with a diagnosis of fractured neck of femur was performed, totalling 71 patients. Thirteen were excluded due to age below 60 or no surgery being performed. The timeline of each of these remaining patients was audited including time from presentation to emergency department doctor review, time to admission and time to surgery from admission. These results were compared to gold standards as outlined by NICE guidelines as well as with results from the Irish Hip Fracture National Database 2015 Report.

Results: A total of 84.5% of patients were seen within 1 hour of presentation; however, there was a delay in admission times, with 34.5% of patients being admitted to a ward within 4 hours of presentation. This is however better than the national figures of 10%. With regards to surgery timing, 84.5% of patients were operated on within 48 hours of admission, compared to a national result of 72%. Overall patients had an average length of hospital stay of 19 days, similar to the national figure of 20 days.

Conclusions: This audit demonstrates that LUH is performing better than the national figures, however there is still significant room for improvement in meeting the current guidelines.

Keywords: Geriatric hip fracture management; National Institute for Health and Clinical Excellence guidelines (NICE guidelines); IHFD key performance indices