The British Society for Surgery of the Hand (BSSH) standards dictate the management of open hand fractures (OHFs). A wound washout and closure (WWC) in an OHF should take place… Click to show full abstract
The British Society for Surgery of the Hand (BSSH) standards dictate the management of open hand fractures (OHFs). A wound washout and closure (WWC) in an OHF should take place within 24 hours of injury if definitive treatment is not possible in that timeframe. A retrospective cross-sectional design was used to collect data from patients with OHFs. Data was taken from Cerner® EPR, Powerchart. Information was gathered about the date and type of surgery, whether surgery took place within 24 hours and, or whether WWC took place within the 24 hour timeframe. Two 3-month audit cycles were carried out: 03/12/2021–24/03/2022 (Cycle 1) and 24/03/2022–24/05/2022 (Cycle 2). Between cycles, simple interventions were implemented, including the distribution of flyers amongst departmental staff and weekly announcements in departmental meetings. Cycle 1 analysed 5 patients with OHFs. Of these patients, 60% (n=3) had definitive surgery within 24 hours and 40% (n=2) had neither definitive surgery nor WWC. Cycle 2 included 13 patients with OHF. Of these, 53.8% (n=7) had definitive surgery within 24 hours, 46.2% (n=6) did not have definitive surgery but had WWC and 16.7% (n=1) did not have surgery or WWC within 24 hours. There was a 30% improvement in the cases for which BSSH guidelines were followed. Simple interventions can lead to significant change in compliance with gold-standards. We aim to conduct further cycles and include other units to assess multi-centre compliance.
               
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