MTP8.09 Evaluating post-operative wound care advice given to patients after emergency general surgery – a quality improvement project

Background Surgical site infections increase inpatient stay, re-intervention risks and NHS costs, highlighting wound care’s importance in post-operative management. Aim To assess whether emergency general surgery patients receive wound care advice as per NICE guideline 125 at a major university hospital. Methods At baseline discharge summaries of post-operative patients over four weeks were assessed for inclusion of dressing advice, showering advice, signs and consequences of wound infection. In Plan-do-study-act (PDSA) cycle 1, a wound care advice template for discharge summaries was introduced, promoted by posters and reminder emails. The template’s accessibility was assessed via a survey. In PDSA cycle 2, a leaflet will be distributed to all post-operative patients and patient satisfaction with information provided will be evaluated. Results At baseline, dressing advice, showering advice and infection signs were included in 51.1%, 19.1% and 40.4% of discharge summaries respectively. In PDSA 1, the corresponding figures were 58.5%, 7.5% and 47.2%, demonstrating similar results. There was significant improvement in infection consequences being addressed (cycle 1: 0%, cycle 2: 15.1%, p =0.05). The staff survey showed that 75% of doctors were unaware of the wound care template and suggested leaflets for convenience. Early PDSA 2 data demonstrate significant improvement in all advice areas. Conclusion Post-operative wound care advice was marginally improved with a discharge summary template. The effectiveness was limited by the changeover of resident doctors, who complete the discharge summaries. As a second intervention, information leaflets will be developed and distributed by ward staff at discharge, ensuring consistent delivery of advice independent of doctor turnover.