85 A Closed Loop Audit of Consent for Trauma and Orthopaedic Surgery in the COVID-19 Pandemic

Abstract

AimSurgical patients with perioperative SARS-CoV-2 infection have increased risks of morbidity and mortality. The primary aim was to audit the inclusion of COVID-19 as a specified risk on trauma and orthopaedic consent forms. The secondary aim was to calculate the indicative risk of acquiring COVID-19 in the perioperative period.MethodCase notes were reviewed for 193 patients, including 160 consent forms, over one-week data collection periods in February 2021 and April 2021, at a Major Trauma Centre. Following the initial audit, data were presented at a departmental governance meeting and an infographic was disseminated to all clinicians. 33 patients, comprising 24 Adults with Incapacity (AWI) and 9 others who had been consented prior to departmental guidance, were excluded from the primary analysis but included in the secondary analysis, where all SARS-CoV-2 RT-PCR test results up to 2 weeks postoperatively were reviewed.ResultsIn the initial audit period, 91 patients underwent surgery (79 consent forms), whilst 100 patients underwent surgery in the re-audit period (81 consent forms). Following our intervention, 70% of patients had COVID-19 specified as a risk on the consent form, representing a statistically significant improvement from 49% in the previous cycle (p = 0.007). During the initial audit, 2 patients tested positive for COVID-19 postoperatively, whilst there were no positive tests during the re-audit.ConclusionsThe consent process for the risk of perioperative COVID-19 significantly improved following our intervention. The indicative risk of acquiring perioperative COVID-19 reduced from 2.15% to less than 1%, which likely reflects the impact of the vaccination programme.