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An audit of compliance with local ultrasound guided Fascia Iliaca Block procedure in Wyong Hospital Emergency Department
EP34342
Poster Title: An audit of compliance with local ultrasound guided Fascia Iliaca Block procedure in Wyong Hospital Emergency Department
Submitted on 30 Oct 2020
Author(s): Dr Anna Tolliday, Dr Hemal Patel, Clare Steel, Dr Nikesh Bhatt
Affiliations: Wyong Hospital, Central Coast Local Health District
Poster Views: 388
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Poster Information
Abstract: Background:
A fractured neck of femur (NOF) is frequently seen in the Emergency Department (ED). Pain associated with a fractured NOF is severe; an ultrasound guided fascia iliaca block (FIB) is the chosen analgesia in Central Coast Local Health District (CCLHD). FIB provides regional anaesthesia, reducing systemic opioid requirements. This reduces adverse outcomes by minimising risk of delirium, reducing length of stay and improving patient experience.

Aims:
1. Observe number of cases of fractured NOF diagnosed in Wyong ED between 01/10/18 - 31/09/19.
2. Measure proportion of cases that had a FIB conducted.
3. Measure average time from arrival to FIB completion.

Methods:
A dataset of cases was provided by Wyong Emergency Quality Project Officer. Electronic medical records (Cerner: FirstNet) was used to identify clinical information.

Results:
1. 41 cases of fractured NOF were diagnosed in Wyong ED between 1/10/18 - 31/09/19.
2. 82.9% (34) had a FIB conducted.
3. Average time from arrival to FIB was 308 minutes.

Conclusions:
Out of 41 cases of fractured NOF, 2 (4.9%) had a relative contraindication. However, only 34 (82.9%) had a FIB conducted, this can be improved.
Average time from arrival to FIB was 308 minutes - a significant delay. This is largely due to shortage of senior staff with procedural skills, coupled with increasing ED presentations.

Recommendations:
Train more staff (inclusive of junior doctors) in the FIB procedure, create an accreditation process to assess competency and facilitate independent performance.
Create pre-made FIB packs to reduce clinician time spent sourcing required equipment.
Summary: An audit of compliance with local ultrasound guided Fascia Iliaca Block procedure in Wyong Hospital Emergency DepartmentReferences: Agency for Clinical Innovation Minimum Standards for the Management of Hip Fracture in the Older Person, Fascia Iliaca Block. Report abuse »
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