587 Preventing Post-Operative Orthostatic Hypotension in Orthogeriatric Neck of Femur Fracture Patients by Encouraging Oral Fluid Intake

Aim This quality improvement project aims to reduce the length of hospital stay in orthogeriatric neck of femur (NOF) fracture patients by preventing orthostatic hypotension during post-operative patient mobilisation through encouraging post-operative, pre-mobilisation oral fluid intake. Method Orthogeriatric NOF fracture patient notes and fluid charts were retrospectively reviewed to establish the pre-intervention baseline post-operative pre-mobilisation fluid intake. A separate cohort of newly admitted geriatric NOF fracture patients were followed prospectively, with an intervention administered one day post-operation to encourage fluid intake. This intervention consisted of a verbal reminder and leaflet encouraging oral fluid intake, along with a verbal explanation and patient information sheet on orthostatic hypotension. Adequate fluid intake was defined as ≥500 ml fluid intake before mobilisation, and a prolonged hospital stay was defined as ≥20 days. This was carried out at the Royal Derby Hospital from July to November 2023. Results A total of 41 patients were reviewed. 21 patients were in the pre-intervention group and 20 in the intervention group. The pre-intervention group had 23.8% (5/21) patients with adequate fluid intake prior to mobilisation. This was increased to 95% (19/20) in the intervention group. The pre-intervention group also had 61.9% (13/21) patients with a prolonged hospital stay which was reduced to 10% (2/20) in the intervention group. Conclusions Encouraging oral fluid intake post-operatively reduces the risk of postural hypotension, empowering patients to mobilise and recover post-operatively, contributing to earlier discharge. Additionally, it may reduce the risk of post-operative acute kidney injury, an avenue which should be further explored.