86 Adherence to Best Practice Tariffs (BPT) for Neck of Femur (NOF) Fracture Admissions During the COVID-19 Pandemic

A. Basha, A. Singh, C. Barmpagianni
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Abstract

Abstract Introduction For patients with fragility hip fractures, care needs to be promptly organised to undertake a holistic assessment and preparation for surgery. The aim of the Best Practice Tariffs (BPT) is to promote hip fracture programmes that provide best practice in the care and secondary prevention of fragility fractures. Method Retrospective audit. Time frame: 11/03/2020 – 22/04/2020. Data retrieved from trauma management and radiology systems. Results Among 33 patients with mean age of 82, 61 % showed compliance to BPT criteria. 39% did not meet the criteria: 33% had delayed surgery >36 hours, 3% had delayed orthogeriatric assessment, and 3% not fit for surgery. 33 % delayed surgeries due to requirement for medical optimisation, and further investigation. Among COVID patients: 41.6 % mortality rate, of which 40 % were perioperative. There was a loss of BPT income (around £17k) during these unprecedented times. However, the provisions of NOF care did not fluctuate despite extreme pressures on our services. Conclusions Ensuring all members of the MDT have access to clinical management system. Implementation of early supported discharge programmes allowed reduction in length of acute hospital stay (from 14.2 in Jan 2020 to 8 in March 2020). Improving access to pacemaker check services.
在COVID-19大流行期间遵守股骨颈骨折入院的最佳实践标准(BPT)
摘要简介对于脆性髋部骨折患者,需要及时组织护理,进行全面评估和手术准备。最佳实践标准(BPT)的目的是促进髋部骨折规划,为脆性骨折的护理和二级预防提供最佳实践。方法回顾性审核。时间框架:11/03/2020 - 22/04/2020。数据来自创伤管理和放射学系统。结果33例患者平均年龄82岁,61%符合BPT标准。39%不符合标准:33%延迟手术至36小时,3%延迟骨科评估,3%不适合手术。33%因医疗优化和进一步调查的需要而推迟手术。新冠肺炎患者死亡率为41.6%,其中围手术期死亡率为40%。在这个前所未有的时期,BPT的收入损失了(大约1.7万英镑)。然而,尽管我们的服务面临极大压力,但非专业人员护理的提供并没有波动。结论确保所有MDT成员都能进入临床管理系统。实施早期支持出院方案减少了急性住院时间(从2020年1月的14.2次减少到2020年3月的8次)。改善心脏起搏器检查服务的可及性。
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