A RETROSPECTIVE AUDIT OF PAIN MANAGEMENT IN PATIENTS PRESENTING WITH HIP FRACTURE

Le résumé fourni par la source

The Agency of Clinical Innovation (ACI) developed seven minimum standards for the management of Hip Fracture across all public NSW hospital departments. Standard two relates to Pain management. The standards were implemented in the Northern Sydney Health District Service [NSLHD] with a population of 887,000 and five public hospitals in 2014. This retrospective case control study reviewed the medical notes of 34 patients with hip fracture admitted to MonaVale Hospital, a metropolitan hospital in Sydney, to identify gaps in Standard Two implementation. ACI data will inform the new Australian and New Zealand Hip Fracture Registry. This 2015 audit assessed pain management in the Emergency department, Peri-operative setting and Rehabilitation. The audit confirmed the elderly population (mean age 86), appropriate assessment of pain scores (hourly upon presentation in 82% of patients). Analgesia prescribing varied across the cohort. Local nerve blocks were used in 35% of patients in Emergency department. Post op analagesia was determined to be reasonable with only 18% of patients reporting severe pain, which may reflect under utilisation of neuropathic analgesia (14%). Inappropriate use of NSAIDS were found in 10% of patients. In response to the audit findings the team are developing a standardised pain pathway during the hospital journey for the patient.

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