Are we good e-NOF? A Twelve-Month Clinical Audit on Fractured Neck of Femur Patients at Wagga Wagga Base Hospital in 2017

T. Pearson, E. Ju, R. Elliott, J. Ellsmore, L. Bennett, B. Barks, S. Krishnan, P. Plunkett, L. Bruce.

Abstract

Neck of femur (NOF) fractures represent a significant health burden to the elderly community and a costly resource strain on the health system. Wagga Wagga Base Hospital (WWBH) is a 460-bed teaching hospital in the Riverina region, and is the only hospital within the Murrumbidgee Local Health District able to provide operative management of orthopaedic conditions such as NOF fractures. We performed a retrospective audit on the management of NOF fractures at WWBH in 2017, and examined data for 199 patients relating to basic demographics, initial management in the emergency department (ED), involvement of medical teams, surgical waiting times, fasting times, intra-operative management and post- operative outcomes. We found that areas that need improvement include the provision of fascia iliaca blocks in ED, transfer times from ED to the ward, implementation of appropriate fasting times, surgical waiting times, more judicious ordering of preoperative echocardiograms, and more thorough documentation of patients’ NFR wishes.