205 A Closed Loop Audit of CT Hip Scanning at Our District General Hospital

Abstract

Abstract Aim This audit aimed to determine whether there was a delay beyond 36 hours in theatre cases due to delayed neck of femur fracture diagnoses for non ambulatory patients with no diagnostic abnormality identified on plain film. We examined the indications for CT scans to ensure a full examination had been documented and a trial of mobilisation had been attempted. Method CT hip scan requests audited retrospectively against whether they delayed surgery, if the scan was discussed with the T&O team, hot reporting prior to the scan request and if there was a full examination with documented weightbearing status. Data was compared with NICE guidelines on hip fracture management (CG214) and expected compliance was 95%. Following the initial audit cycle, teaching was given at A&E induction on the referral process and pathway and subsequently re-audited. Results Documented full examination improved from 85 to 93%. Weightbearing status was documented in 33% initially and 76% following the re-audit. There was a 44% improvement in the number of patients who had scans hot reported prior to CT scan occurring. In 95% of patients CT scan did not delay surgery beyond 36 hours. Conclusion CT scan delays did not lead to a delay in the 95% of patients going to theatre. However, with normal plain films it is crucial to have a documented attempt to weight bear prior to the CT request being made. Hot reporting of hip radiographs can be useful prior to requesting CT scans though reporting times and clinical workload can limit this factor.