825 Hip Fractures in the Emergency Department: Are we keeping to the Big Six Standard?

Abstract

Abstract Introduction Hip fractures are the most common serious injury in older people (1) with 7364 patients attending the Emergency Department (ED) with a hip fracture in Scotland in 2019 (2). The “Big Six” are key areas in the acute management of hip fractures as outlined in standard 2 of the Scottish Hip Fracture Audit (SHFA): New Early Warning Score; cognition; Water Low Pressure Score; intravenous (IV) access and bloods; nil-by-mouth and IV fluids; and analgesia. In 2019, Ayr ED had a compliance rate of approximately 37.5% with the “Big Six” (2). Method One month of hip fracture data (n = 20) relating to the “Big Six” was collected from the Symphony software and audited. Areas where improvements could be made were highlighted to staff, and a further one-month data collection (n = 17) was carried out. Results From the first to second round the “Big Six” checklist completion rate increased from 30% to 41% (p = 0.68) and the “Big Six” compliance increased from 60% to 71% (p = 0.5). Conclusions In conclusion, compliance increased by 11% with the “Big Six”, however, not to the defined standards identified in the SHFA. Further long-lasting interventions have now been made to ensure that compliance rates continue to improve along with our standard of care.