Improving prescribing of antiosteoporosis discharge medication in fractured neck of femur patients: a completed audit cycle

Abstract

Fracture liaison specialist nurses at our institute, perceived deficiency in the level of prescription of osteoporosis secondary prevention medication on discharge of fractured neck of femur (NOF) patients. This aspect of management was therefore audited over two cycles with the aim of evaluating and improving current practice. A prospectively maintained database was utilized to establish identity, demographic data and specialist nurse treatment recommendation for all fractured NOF patients over an initial 12-month period. Computerized immediate discharge letters were reviewed to identify whether the recommended medication had been prescribed. Following the initial audit, fluorescent drug kardex stickers detailing simple treatment recommendations were introduced, and a second audit cycle was carried out using identical methods over the subsequent 12-month period. Primary audit demonstrated that discharge prescriptions included the recommended secondary prevention medications in 50.9%. Following the introduction of fluorescent drug chart stickers detailing the recommendations, re-audit demonstrated improvement to 84.6%. In conclusion, an improvement in the practice of prescription of osteoporosis medications on discharge was demonstrated following the introduction of fluorescent drug kardex stickers.