91 Introduction of a Simple Proforma Improves Documentation of Neuro-Vascular Status in Paediatric Supracondylar Humerus Fractures (Closing Loop Audit)

Abstract

Abstract Introduction Supracondylar fractures of the humerus are the most common fracture around the elbow in children. There is a risk of significant complications including nerve injury, vascular compromise, compartment syndrome and clinical deformity. BOAST (British Orthopaedic Association Standards for Trauma) published guideline 11 in 2014 (updated in Oct 2020) which lists criteria that should be assessed and documented for each child with this injury. Aim Assess whether an introduction of a simple proforma will Improve documentation of the neuro-vascular status in paediatric supracondylar humerus fractures. Method a closing loop Audit to review the accuracy of documentation of the neuro-vascular status in the admission clerking against the standards published in the updated BOAST guidelines both before and after introduction of a simple documentation proforma. Results In the first audit cycle 30 patients were included and detailed documentation of the Neuro-vascular status as per the BOAST guideline was less than 40 %. After the proforma was introduced, the second closing loop cycle included 31 patients and detailed documentation of the Neuro-vascular status as per the BOAST guideline was 70 %. Conclusions The introduction of a simple proforma has improved significantly the documentation of the neurovascular status in children presenting to the ED with a supracondylar humerus fracture.