796 THE IMPORTANCE OF CHEST X RAYS AS AN INITIAL INVESTIGATION IN ROUTINE ACUTE ELDERLY CARE ADMISSIONS

Abstract

Abstract Introduction The Chest X-Ray (CXR) is a common and central initial investigation for any patient that has been admitted via Accident and Emergency (A&E). In the context of elderly care, it is a useful measure of a patient’s baseline functional status as well as a tool for cancer surveillance and other aspects of clinical care. Accurate documentation of CXR review is also imperative for closed loop communication of clinical information amongst a multi-disciplinary team. Methods Twenty-eight random inpatients in a local NHS Trust Healthcare of Older People (HCOP) department were selected to be part of this two-cycle study. Using hospital database records, the CARESTREAM imaging system and patient clinical documentation, data including the following was collected: whether a CXR was completed, was CXR review documented in patient notes and initial reason for admission. As per local practice, all acute HCOP admissions should undergo a CXR and have an image review clearly documented in patients’ clinical noting. The established target was 95% compliance for both. Following intervention by way of ward poaters and presentation at a local quality improvement meeting the cycle was repeated to ascertain improvement in compliance. Results 22 (79%) HCOP patients had a CXR on admission. Of those completed CXRs, only 6 (27%) of these showed evidence of review (documentation in clinical noting). Following the above mentioned interventions, 25 (89%) of HCOP patients had a CXR on admission, showing an improvement. Of those completed CXRs, 20 (80%) showed evidence of documented clinical review– once again showing improvement. Conclusions CXRs and their accurate documentation is an important aspect of the holistic care of the HCOP patient. Ensuring that compliance for completing the scan and documenting results should be a priority in clinical quality and safety. Our interventions have shown an improvement in compliance and resulted in sustainable change.