Documentation of neurovascular assessment in fracture patients in a tertiary care hospital: A retrospective review

Abstract

IntroductionNeurovascular problems are common in acute fracture. In the emergency room, a thorough clinical evaluation is required, when examined by an orthopedic specialist or emergency doctors. Materials and methodswe registered our project with the audit department. In the first cycle, we looked at notes from 77 patients from November–December 2020, emphasis to neurovascular documentation from both ED and orthopedic Clerking notes. We submitted our findings at our audit meeting and implemented modifications. Two months later, we re-audited, this time with 82 patients as the sample size. Results77 patient notes were reviewed in the first cycle, 51% male and 49% female. In ED clerking notes, 22% patients had no neurovascular documentation, compared to 3.8% of patients in orthopedic clerking. 39% ED notes had acronyms written for the neurovascular status, such as NVI, to 20.7% of orthopedic notes. 82 notes were reviewed in the second cycle,44% male and 56% female.7% of ED clerking notes lacked any neurovascular comments, compared to 0% of orthopedic admission sheets. 10% of the ED sheets contained NVI abbreviation, while 4% of ortho notes had the same. There were specific notes on neurovascular state on 68 of the ED admission sheets evaluated, and 74 of the orthopedic notes did the same. ConclusionIn fracture patients, documentation of neurovascular condition was lacking. The documentation of the details of the neurovascular assessment was poor. Increased recording of neurovascular assessment and improved emergency department evaluation of patients presenting with upper and lower limb injuries were aided by the introduction of teachings.