1010 Assessing Completion of Check Radiographs in the Trauma and Orthopaedic DepartmentB Taiwo, E Menyah, S Garcia
Postoperative check radiographs are routine practice in Trauma and Orthopaedic surgery, allowing for radiographic assessment of components and evidence of bony injury (1). All trauma cases requiring postoperative imaging as per operation note should have this completed in a timely fashion.
Patient records were assessed over 4 months across two sites within an NHS Trust to determine the following - Time from surgery to request of post-operative radiograph, time from request to completion of radiograph, and evidence of a documented review in patient notes.
120 patients at site 1 and 134 at site 2 were assessed. At site 1, 11 patients did not have radiographs completed before discharge in comparison to 2 patients at site 2. The average time from surgery to radiograph request was 2.26 days at site 1, 1.07 days at site 2. The average time from request to completion of radiograph was 2.25 days at site 1 and 0.95 days at site 2. Documentation of review of radiographs was poor across both sites. A patient discharged prior to check radiograph re-attended hospital with a dislocation of hip hemiarthoplasty.
Numerous recommendations were made to ensure that good practice was established across sites. Operating surgeon or assistant should request post-operative imaging, at the same time as completion of the operation note. A trial of intra-operative fluoroscopy for hip hemiarthroplasty at Site 2 was started to see whether this could streamline current processes.