Information Posters Research Articles

P-1769. Improving Surgical Prophylaxis for Patients with Penicillin Allergy Label

Abstract Background Patients with a penicillin allergy label (PAL) have an increased risk of surgical site infection when receiving a β-lactam alternative for surgical prophylaxis. The updated 2022 Drug Allergy Parameters support the use of cefazolin for patients with a penicillin allergy history including anaphylaxis. We evaluated antibiotic use for surgical prophylaxis in a large academic center. Methods We performed a quality improvement intervention to decrease inappropriate use of non-β-lactam antibiotic surgical prophylaxis in patients with PAL at a 1091-bed tertiary hospital. Beginning in 10/2018, we provided education at anesthesia grand rounds and surgical safety meetings regarding preferential use of cefazolin in patients without severe PAL. In 12/2023, we updated institutional guidelines to recommend cefazolin use in all patients except those with history of anaphylaxis to cephalosporins, isolated hives to cefazolin, and β-lactam-associated severe cutaneous drug reactions. This was communicated to anesthesia and surgery stakeholders. Peri-operative antibiotic prophylaxis alert cards were hung in the operating rooms (Figure 1) and clindamycin and gentamicin were removed from OR medication-dispensing machines (ORMD). Results There was a significant decrease in clindamycin use from 11.2% in the pre-education period to 6.2% after education, further reduced to 1.7% since updating institutional guidelines and removing clindamycin and gentamicin from ORMD. Concurrently, cefazolin use increased from 9.0% to 26.0% to 39.5% in the same periods (Figure 2). This was seen across surgical services (Figure 3). Decreases were also seen in gentamicin use. There was no significant change IV vancomycin use as an alternative for patient with PAL. There was no increase in episodes of perioperative anaphylaxis related to these interventions. Conclusion There remains significant opportunity to optimize surgical prophylaxis for patients with PAL. QI efforts such as acquiring stakeholder support and development and dissemination of teaching materials were effective in reducing suboptimal perioperative antibiotic prophylaxis. Informative posters at point of care and removal of clindamycin and gentamicin from OMRD further reduced inappropriate surgical prophylaxis in patients with PAL. Disclosures All Authors: No reported disclosures

Evaluation of the Effectiveness of Vector Management Methods in Hospital X Batam City

According to the Ministry of Health, disease vector and pest management includes all actions or activities aimed at reducing the population of disease vectors and animals as low as possible so that their presence in an area no longer poses a risk of disease transmission. The purpose of this study is to determine the Input, Process, and Output aspects of evaluating the effectiveness of vector handling methods in Hospital X in Batam City. This study used qualitative methods through in-depth interviews and observations with a total of six informants, namely the Head of Subdivision of Public Facilities, Head of Public Facilities Affairs, Health & Safety Coordinator, Human Resources, Head of Finance, 3rd agent (CV. Bumi Resik). The results of this study indicate that vector handling in Hospital X has been quite effective, lack of awareness of Human Resources of the prohibition of leaving food scraps in the work room. It is necessary to collaborate with entomologists to get advice and vector handling strategies that are more effective and specific according to the conditions of Hospital X, apply strict sanctions for those who violate the prohibition of leaving food scraps in the work room, provide informative posters in the hospital area about simple procedures that can be done to support vector handling

Epiphytic Orchids in the Flora of Ecuador: a Review of Their Richness, Abundance, Ethnobotanical Importance, and Conservation Strategies in the Context of the Sustainable Development Goals SDGs

Objective: The objective of this study is to describe the current status of the Orchidaceae family with respect to its conservation in the Canton Lago Agrio. Determine the richness and abundance of orchids in the Canton Lago Agrio. 2. Determine the ethnobotanical importance of the orchids of the Canton Lago Agrio. 3. To establish conservation strategies for the most representative orchids of the Lago Agrio Canton. Method: The methodology adopted for the research included field trips through direct and random observation, the use of taxonomic identification guides, an exhaustive bibliographic search in high impact databases such as Scopus and Web of Science, and the application of expert judgment. Results and Discussion: The results revealed the richness and abundance of orchids within the Lago Agrio canton. 42 species and 497 individuals, each of them with epiphytic habit. The importance of this taxonomic group lies in economic factors, such as, commercialization of specimens, use in medicine and gastronomic taste. Its main conservation strategies are environmental education and the implementation of informative posters in educational centers and natural spaces, such as natural parks. Research Implications: The results of this study have implications for orchid planning and conservation in Lago Agrio Canton. The research underscores the need for a multidisciplinary approach to taxonomic conceptualization and conservation, as well as the importance of considering the landscape as a central element in the development of sustainable tourism products and experiences. Originality/Value: This study contributes to the literature by providing a comprehensive and up-to-date review of the relationship between the natural landscape and orchid conservation status, bringing together knowledge from various disciplines.

"My Baby's Sleep": A Quality Improvement Project to Promote Safe and Healthy Sleep Practices.

Introduction Promoting healthy sleep practices from birth has a positive effect on infants and their families. Our goal was to implement measures to promote safe and healthy sleep practices for infants and to evaluate their impact. Methods A quality improvement project was developed in the maternity ward of a level II hospital in Portugal. The study comprised three phases: evaluation of the information provided to parents and infants' sleep habits by a telephone survey between two and three months of age; intervention through the application of measures, which included informative leaflets, posters, and training sessions for medical and nursing staff; and evaluation of the implemented measures after one year, applying the same survey. Results We recorded an increase of 13% in parents informed about safe sleep surfaces (p=0.001) and position (p<0.001). Additionally, 19.3% more infants were sleeping in the supine position (p<0.001). Only 74.7% were sleeping in a crib, and bed sharing was still a common practice (20.9%). Regarding sleep habits, we recorded a 7.6% increase in infants sleeping in the dark at night (p=0.216), and a 17.2% increase in the use of the night light (p=0.003) for diaper changes/feeding. Discussion Our project was effective in improving parents' knowledge concerning safe sleep practices, increasing the proportion of infants sleeping in the supine position, and reducing light exposure at night. However, we had no effect on bed sharing, which remains frequent, related to our population's cultural background.

Reconditioning For Discharge; An OT-Led Initiative

Abstract Background Deconditioning is the loss of functional ability in frail older adults (BGS, 2017). Many initiatives such as #EndPJParalysis address the importance of preventing functional decline in acute settings. Occupational therapists (OTs) are best equipped to lead these initiatives due to the holistic nature of the profession. This initiative aimed to complete an educational campaign among staff, patients and families about the importance of preventing deconditioning. Audit approval was granted by hospital Clinical Audit Committee. Methods An observational audit of patient presentation at ward level was completed. Data was gathered on clothing and sitting out status as a baseline measurement. A PR and staff education campaign was instigated. Information leaflets and posters for patients, families and staff were distributed. A re-audit was completed after 1 month. Results Patients in their own clothing/pyjamas increased by 8%. Patients sitting out of bed increased by 11%. Informal positive feedback from patients, families and staff suggested a cultural shift on the ward with regards to promoting patients independence. Conclusion Improvements post initiative were noted, however, a longer duration of the initiative would be beneficial to further promote reconditioning. OTs’ comprehensive approach is best placed to champion this reconditioning initiative. Further roll out of the campaign throughout the hospital may be of benefit. There is a wealth of educational/PR resources available for same. Reference British Geriatrics Society (2017) Deconditioning awareness, British Geriatrics Society. Available at: https://www.bgs.org.uk/resources/deconditioning-awareness (Accessed: 19 April 2024).

Education on Adolescent Reproductive Health at MTsS Thawalib Pesantren Padang

Adolescents are faced with many problems related to reproductive health, so adolescents need to know to be able to face these challenges. However, the knowledge of adolescents in Indonesia is still low, especially in terms of ways to protect themselves against reproductive health risks, such as preventing unwanted pregnancies, sexually transmitted infections, and AIDS. The provision of education needs to be done to address adolescent reproductive health problems. Educational activities related to reproductive health at MTsS Pesantren Thawalib Padang have never been conducted. The students MTsS are the right target group to be able to provide information related to reproductive health. The objective of this service activity is to enhance students' understanding of reproductive health, enabling them to cultivate a positive and responsible approach when addressing the sexual and reproductive changes that transpire within them. The approach employed involves student outreach and the placement of informative posters in their dormitories. The augmentation in students' knowledge was assessed using a questionnaire consisting of 15 questions before and after the activity. Data analysis was conducted through a paired sample t-test, a statistical method that compares the means of two related groups to determine if there is a significant difference between them. After the activity was carried out, there was an increase in the average level of knowledge before (pre-test), 40.63 to 49.76 after (post-test), providing education with a p-value of 0.000. It can be concluded that there is an increase in knowledge after adolescent reproductive health education. It is hoped that students can access reproductive health information from the posters displayed on the dormitory walls.

Fourth COVID anniversary: does our practice have changed? The case of ENT outpatient consultations in Cameroon — a national cross-sectional survey

BackgroundIn Cameroon, the COVID-19 disease has demonstrated shortcomings in preventing nosocomial infections at both collective and individual levels. This study aimed to identify practice changes in ENT outpatient consultations in Cameroon inducted by the COVID-19 pandemic.MethodsThis was a descriptive cross-sectional study that took place in March 2024. A Google Form was submitted to ENT practitioners online across Cameroon. It consisted of 20 questions grouped into socio-professional and clinical data.ResultsSixty-four practitioners responded to the questionnaire. The average age of respondents was 36, with extremes of 31 and 70. The sex ratio was 0.35 in favor of women. In terms of experience, 47.7% had been practicing for less than 10 years. A total of 91.3% practiced in public health facilities. Before the COVID-19 outbreak, attitudes towards respiratory diseases were as follows: wearing of masks by suspected patients (4.3%), information posters in waiting rooms (13%), constant use of disinfectant gel (26.1%), wearing of masks by practitioners (0%), wearing of gloves (54.5%), wearing of gowns (87%), constant hand hygiene after each consultation (26.1%), and regular surface hygiene (30.4%). All precautions were improved after 4 years of the pandemic except wearing eye protection.ConclusionENT practice has been strongly impacted by the COVID-19 pandemic, and many measures still need to be taken to improve infection control in hospitals in Cameroon.

Lessons for a learning health system: Effectively communicating to patients about research with their health information and biospecimens.

Sharing patient health information and biospecimens can improve health outcomes and accelerate breakthroughs in medical research. But patients generally lack understanding of how their clinical data and biospecimens are used or commercialized for research. In this mixed methods project, we assessed the impact of communication materials on patient understanding, attitudes, and perceptions. Michigan Medicine patients were recruited for a survey (n = 480) or focus group (n = 33) via a web-based research study portal. The survey assessed the impact of mode of communication about health data and biospecimen sharing (via an informational poster vs. a news article) on patient perceptions of privacy, transparency, comfort, respect, and trust. Focus groups provided in-depth qualitative feedback on three communication materials, including a poster, FAQ webpage, and a consent form excerpt. Among survey respondents, the type of intervention (poster vs. news) made no statistically significant difference in its influence on any characteristic. However, 95% preferred that Michigan Medicine tell them about patient data and biospecimen research sharing versus hearing it from the news. Focus group participants provided additional insights, discussing values and perceptions of altruism and reciprocity, concerns about commercialization, privacy, and security; and the desire for consent, control, and transparency. Developing our understanding of patient data-sharing practices and integrating patient preferences into health system policy, through this work and continued exploration, contributes to building infrastructure that can be used to support the development of a learning health system across hospital systems nationally.

ThP6.13 - A closed loop clinical audit on adherence of weight-based and renal function-adjusted venous thromboprophylaxis prescribing to local guidelines in emergency general surgical patients

Abstract Aims to audit adherence of venous thromboembolism (VTE) prophylaxis according to local trust guidelines in a single-centre emergency general surgery department, adjusting doses based on weight and renal function (creatinine clearance). Following initial audit of practice, intervention to improve local practice was implemented with informative posters and teaching sessions, aiming to improve overall adherence to guidelines and limit risk of complications from incorrect dosing. Methods A two-cycle snapshot audit of VTE prophylaxis prescribing was conducted in a district general hospital emergency general surgery department against local guidelines concerning VTE prophylaxis. All current inpatients admitted under general surgery were included in the study reviewing baseline characteristics including age, weight, and creatinine clearance. Results The first cycle audited the adherence of departmental practice against guidelines in 57 inpatients. 49 (86.0%) were prescribed VTE prophylaxis in accordance with local guidelines. Of the 8 patients who did not adhere to guidelines, 5 (62.5%) had no VTE prophylaxis prescribed, while 3 (37.5%) had incorrect doses prescribed for their weight or renal function. The second cycle audited 43 inpatients. 39 (90.7%) adhered to guidelines. All re-audited patients had the correct VTE prophylaxis prescribed, although there was no VTE prophylaxis prescribed in 4 (9.3%) patients. There were no bleeding or thromboembolic complication in any patients over the course of admission in both cycles of this audit. Conclusion Adherence to local guidelines concerning VTE prophylaxis was increased following intervention. This eliminated VTE prophylaxis prescribing errors, although did not improve the amount of VTE prophylaxis prescription omissions.

The Health Education on Adolescent Reproductive Health Through a Festival Competition for Indonesia's Independence Day Celebration

In 2030, Indonesia is projected to experience a 37% increase in the number of HIV-positive patients, marking an addition of approximately 13,576 cases over 11 years. East Java, particularly among the 25-49 age group, predominantly males, stands out with the highest HIV prevalence. Factors such as inadequate knowledge among adolescents about reproductive health, exposure to pornography, and parental disempowerment contribute to risky sexual behaviors. The Activity aims to enhance adolescent reproductive health awareness, reduce HIV/AIDS cases, and supports preventative efforts at SMPN 15 Surabaya, Kenjeran, Surabaya. The community service activities encompass smart quiz seminars, educational role-playing, and informational posters. A questionnaire with 15 questions serves as metric for the success of the outreach. To analyze the methods' outcomes and effectiveness Descriptive and inferential statistics are applied. The community service initiatives successfully garnered participation from 108 students out of a total of 900 at SMPN 15 Surabaya. The seminar quiz activity with ρ-value ≤ 0.05 significantly increased students' knowledge by 14%, while role-playing and poster competitions showed no significance. Hence the festival has positively contributed to students' knowledge enhancement, particularly through the smart quiz seminar.

Layout Generation: Automated Components Placement for Advertising Poster using Transformer-Based from Layout Graph

In the digital era, graphic design plays an important role in a company's marketing strategy, especially advertising posters that can convey messages to the audience. However, the process of making attractive and informative posters takes a long time, especially in the placement of components in the layout. This research aims to develop a layout generator system that focuses on placing components on the layout using the SGTransformer method. SGTransformer is one of the transformer-based methods that can be used to generate layouts. This research utilizes the capabilities of Laplacian positional encoding (LapPE) and edge features in SGTransformer that can improve the model's performance in developing a more structured layout based on the input layout graph. A layout graph describes the spatial relationship between components in a layout. The SGTransformer model is trained using advertising poster datasets collected from social media. Once trained, the model automatically places components based on the description of the spatial relationship between components represented by the layout graph. Evaluation of the model shows that the SGTransformer method can produce structured and more diverse layouts although there are still challenges such as overlap between components. This research contributes to the efficiency of the advertising poster design process and provides practical solutions to the creation of advertising posters in the digital marketing industry. Code and other materials will be released at https://github.com/syahdeee/Layout-Generator.

2275 Enhancing delirium awareness among patients’ relatives: a quality improvement project in elderly care

Abstract Aim This Quality Improvement Project (QIP) addressed the pressing need for increased awareness of delirium among patients’ relatives. With a 26% rise in the elderly population in Cambridgeshire, surpassing the 18.6% national average, the project provides crucial information to enhance patients’ relatives access to information about delirium, a condition affecting up to 50% of older hospitalised patients. Method This prospective QIP was conducted across seven Cambridge University Hospital (CUH) geriatric wards. Qualitative surveys determined delirium awareness, understanding, interest and perception of information availability among patients’ relatives with delirium. Measurements included data on the views of online Trust delirium information. Interventions included designing a new eye-catching delirium information poster with a QR code linked to the Trust delirium information leaflet, strategically placing QR code-enabled posters in wards, awareness campaigns targeting healthcare professionals, liaison with the inpatient Dementia team, and targeted communication at Dementia and Delirium Champion training sessions for nursing and healthcare staff. Results Pre- and post-intervention questionnaires, involving 13 relatives visiting these wards, showed a 16%, 10% and 20% respective increase in respondents’ awareness, understanding, and interest in delirium. There was a 29% increase in awareness of location of delirium information post intervention. After the interventions, views of the Trust delirium website increased by 132%. Cycles of the QIP highlighted the importance of laminated posters to comply with infection control measures and the need liaison with ward teams about strategic poster placement. Conclusion this QIP successfully demonstrated the effectiveness of QR code enabled access to patient/relative information and that a multi-faceted approach is required to facilitate effective information provision. We also demonstrated these measures increased delirium awareness in relatives. Future recommendations include continuous monitoring of the availability of posters within clinical areas, content evaluation, and work with the Dementia team to roll this out to all wards with older people within Trust.

Assessing perceptions of flea and tick infestation risk in Southeast Queensland, Australia

Social cognitive models are useful for improving our understanding of the relationship between people's health beliefs and disease risks and have been widely employed in human medicine. In veterinary science, there is little research about owners' perceptions of pet health and parasitic infections/infestations, despite the risk of transmission of zoonotic pathogens by ectoparasites. This study investigated the effects of demographic factors on pet owner's perception of ectoparasite infestation risk and behaviours related to animal health in southeast Queensland, Australia employing the Health Belief Model (HBM). A total of 241 dog owners were surveyed in 2018. The electronic survey was generated through SurveyMonkey and distributed utilising UQ SVS and Royal Society for the Prevention of Cruelty to Animals (RSPCA) email networks, informative posters and brochures placed in selected veterinary clinics, and in-person visits to dog parks. The relationship between dog owners' perception of flea and tick infestation risk was assessed using an adaptation of the Health Belief Model, social cognitive framework for health protection. Most survey respondents were between 26 and 45 years of age (40%), identified themselves as females (83%) and had a bachelor's degree (43%). Our results indicate that female owners had greater level of health concern related to ectoparasites compared to males. Similarly, owners aged 18 to 25, with a grade 10 to 12 level of attained education and living predominately in a rural setting showed greater level of health concern related to ectoparasite infestations. The results also indicated that cat owners had on average, higher levels of health concern than dog owners. Our study indicates that the perceptions of pet owners towards perception of flea and tick infestation risk varies demographically, and owner education is an important predictor of prevention behaviours towards tick and flea infestation of pets.

KKN TEMATIK : MEMBANGUN KESADARAN MELALUI EDUKASI SEHAT KEUANGAN SEHAT MENTAL BERSAMA MASYARAKAT DI KECAMATAN KLOJEN KOTA MALANG, JAWA TIMUR

The Community Service Program (KKN) conducted on Jalan Ijen Oro Oro Dowo, Klojen District, Malang City, East Java, focuses on the "Financial Health and Mental Health" campaign. This program aims to increase public awareness and knowledge about the importance of good financial management and maintaining mental health. The target audience includes a broad spectrum of the community, from those without income to those who are already earning. The methods used in this campaign include direct education, distribution of informative posters, and provision of basic food packages. Financial education covers topics such as tips for managing finances, the importance of saving, budgeting, and avoiding unnecessary debt. Meanwhile, mental health education highlights the importance of maintaining mental health, ways to cope with stress, and the importance of seeking professional help if needed. The results of this activity show an increased understanding among the community about both topics discussed. Active participation from the community during the Q&amp;A session indicates a high level of interest and need for this information. The distribution of educational posters helped reinforce the messages conveyed, and the provision of basic food packages had a positive impact on those in need. Overall, this activity successfully achieved its objectives and received positive feedback from the community. It is hoped that similar activities can be conducted regularly to continuously improve the welfare and quality of life of the community in Klojen District.

Delirium is not dementia: Delirium Awareness Day-related event at the University Hospital in Krakow.

To present the two-day Delirium Awareness Day-related event held at the University Hospital, Kraków, Poland. Activities included a lecture, a multimedia presentation, meetings with healthcare workers at their respective wards, and distribution of information posters about delirium. Local news outlets were also engaged. We reached out to approximately 300 persons in the hospital itself and several thousand via TV and radio broadcasts. We prompted interdisciplinary discussions about delirium, especially concerning preventive measures. The most common questions were how to alleviate symptoms as soon as possible, with the expectation of straightforward solutions for the non-geriatrician staff. Patient distress and burden on caregivers were important topics brought-up in the discussions. We demonstrated that our educational initiative was feasible and well-accepted among medical staff. Local media helped in building public understanding of delirium. Education about the syndrome should be one of the key societal tasks of geriatricians.

Devising of a risk map on the management of high risk alert medication in a high level university hospital

ObjectiveTo classify hospital units into three risk levels in order to define and prioritise improvement and training measures in each of them. MethodThe risk map was developed in two phases: First phase involved the setting up of a multidisciplinary team, a bibliographic search, the identification of medications and of the criteria to design the map: (1) Location: number of high-alert medications; (2) Staff turnover: the units were classified in low turnover units = 1, medium turnover units = 2 and high turnover units = 3 according to data provided by the human resource department; (3) Frequency: quotient between the number of high alert medicactions in each unit and the total of medications used, and (4) Severity: voluntary survey of professionals. An accumulated risk of severity of each unit was calculated: Σ (severity of the drug x number of its units). The Neperian logarithm was applied to this value to reduce the variability of the values. Thus a risk probability index was established = staff turnover x frecuency x Neperian logarithm of severity. In a Los artículos publicados en esta revista se distribuyen con la licencie Articles published in this journal are licensed with a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. http://creativecommons.Org/licenses/by-nc-sa/4.0/ La revista Farmacia no cobra tasas por el envío de trabajos, ni tampoco por la publicación de sus artículos. second phase, the units were classified into three groups and the risk map of high-alert medication was elaborated in the hospital. In it, the units that had a risk probability index higher than 2.9 were classified as high risk units, those that had between 1–2.9 as intermediate risk units and those that had less than 1 as low risk units. According to the risk probability index, improvement measures were defined and priorities were set for each of them. ResultsA total 447 high-risk medications corresponding to 227 active ingredients were identified during the study period. The units showing a higher risk were: Intensive Care Medicine (10.51), Reanimation (4.01), and Palliative Care (3.90). Improvement actions (informative poster, visual identification, alerts, training and double checks) were defined and prioritised in accordance with the risk probability index. ConclusionsKnowing the degree of risk of hospitalization units in the management of high-alert medications allows for the implementation of improvement plans in relation to the degree of vulnerability detected.

Active recreational and silvicultural co-use of forested areas: an innovative forest management study

Abstract Issue Forests are crucial in the sustainability transition to a biobased modern society. However, forests may also be recreational sites, and positively affect human health and well-being. Modern silvicultural harvesting practices alters the landscape overnight, and hence may affect the recreational and public health promoting use of it. Description of the problem Municipalities, as owners of urban forest areas, may actively support inhabitants’ recreational use of near-by forested areas by 1) allocate resources to local voluntary organizations who facilitate for recreational users and 2) actively facilitate for continuous recreational use while practicing modern silviculture. In 2020-2022, an innovative integrative forest management approach was tested in a municipality in mid-Norway. This study explores how the local forests are used for recreational purposes, and how potential conflicts in land use can be mitigated or prevented. Results The forest areas are mostly used for health-promoting activities like exercise, walking, general recreation, and seasonal harvesting of wild berries and mushrooms. Half of the users get to the forest by foot or bicycle. Easy access, closeness to home, free parking arrangements and access to maps of the areas is important to users. Most users were well-informed about local forest-based businesses and carbon sequestration in wood and held that forests should be harvested and regenerated. They showed a high tolerance for forestry if the footpaths were cleared immediately. However, three out of four users want to be informed before harvesting. A small share of users wants educational posters about forest ecosystems. Lessons A pre-existing low conflict level between modern forestry and recreational forest use may be maintained by quite simple and modest means. In this municipality information posters were placed by the footpaths and an arena for discussions, information and co-creation of recreational facilitation was established in 2022. Key messages • Near-urban forests are frequently used for exercise and recreational activities, especially if easily accessible. • Harmonious co-use of forest areas, even in times of timber harvesting, is supported by rapidly recovering the footpaths and by notifying inhabitants in advance.

366 Vitamin D3 Assessment and Supplementation in Elderly Hip Fracture Patients: A Closed Loop Quality Improvement Project

Abstract Aim to improve the assessment and supplementation of vitamin D3 in elderly hip fracture patients in a trauma unit. Method This is a single-centre quality improvement project utilising the PDSA cycle based in a trauma unit covering the black country within the West Midlands. Data was collected retrospectively using the National Hip Fracture Database and hospital electronic systems such as clinical web portal, ICE, GP records, edischarge and ePMA. Inclusion criteria consisted of patient age greater than 60 with a radiologically confirmed neck of femur fracture, treated operatively with an orthogeriatrics review within 72 hours of admission, and COVID-19 negative PCR. Pre-intervention data included 15 patients from July 2020. We assessed 3 parameters including pre-admission vitamin D3 supplementation, measurement of vitamin D3 during admission and vitamin D3 supplementation on discharge. Interventions placed in February 2021 comprised of a postoperative hip blood profile pathway on ICE and guidelines on how to order bloods were circulated with information posters. In addition, teaching sessions for doctors and nurses with twice weekly orthogeriatric reviews emphasising bone protection. Post-intervention data included 15 patients from April 2021. Results Improvement in vitamin D3 level assessment during admission; 20% to 93.3% however, decline in vitamin D3 supplement prescribed on discharge; 73.3% to 26.7%. Conclusions Interventions showed an improvement in quality of vitamin D3 assessment however, the decline in supplementation on discharge may be due to further planned intravenous bone protection bisphosphonate therapy and miscommunication due to ward doctors rotating every 4-6 months on how to appropriately assess and supplement vitamin D3 levels.

463 Adherence to Extended Venous Thromboembolism Prophylaxis for Post Operative Resection of Colorectal Malignancies

Abstract Aim Patients undergoing cancer resection abdominal surgery are at high risk of developing venous thrombo-embolism (VTE) in the post-operative period. To reduce this risk, these patients should be considered for extended pharmacological VTE prophylaxis for 28 days post-surgery as per NICE guidelines (NICE NG89). In our surgical department, we give all colorectal cancer resection patients 5000 units of Deltaparin for 28 days post resection unless it is contraindicated. We aimed to evaluate adherence to this guideline. Method This is a single-centre retrospective audit study. We included 100 colorectal cancer resection cases between 1st October 2021 and 28th February 2022 (n = 100). Retrospective data was collected including the type of procedure, histology and whether post-operative Deltaparin was prescribed for 28 days. All consecutive colorectal cancer resections were included in the study. The data was collected from the patient electronic records, electronic prescribing system and the electronic discharge summaries. Results The most common operation was anterior resection of the rectum (42%) followed by right hemicolectomy (40%). The Adherence to the NICE guidelines for extended VTE prophylaxis was 87%. Conclusions The adherence to the NICE guidelines in our department falls below the national target of 90% adherence. To improve the compliance, we will carry out staff education on appropriate anticoagulation prescribing and also display informative posters in the surgical wards to increase the awareness. We will aim to re-audit the adherence to the guidelines after implementing these measures.

613 The Use of an Online Sepsis Screening Tool to Improve the Initial Management of Sepsis

Abstract Aim The aim of the project was to improve the adherence to sepsis management guidelines in Trauma and Orthopaedic patients through the use of an online Sepsis Screening Tool (SST). This was created to increase recognition of the early signs of sepsis to guide time critical interventions thus improving patient care. Method A retrospective audit of adult Trauma and Orthopaedic inpatients with a NEWS2 score of over 5, or 3 in one parameter, or a new suspected infection within a seven-day period was conducted in July 2020, March 2021 and August 2021 for each audit cycle respectively. We then assessed whether the SST and time critical interventions had been completed. Results After the initial audit in July 2020 showed the use of the SST and achievement of time critical interventions was poor, we introduced several interventions including information posters, and sepsis teaching for junior doctors. Further interventions were implemented after repeat audit cycles, including the incorporation of the SST within daily nursing safety huddles. By August 2021 the use of the SST had increased from 10% to 54%. This was associated with improved adherence to the sepsis management guidelines including correct observation frequency and medical review within 1 hour. Communication of a sepsis diagnosis to patients and family members also improved. Conclusions The completion of the SST increased adherence to sepsis management guidelines in our patients. We therefore recommend the use of Sepsis Screening Tools to identify patients at risk of sepsis and to improve their initial management.