649 Retrospective Audit into Management of Periprosthetic Joint Infections as per National and International Guidelines

Aim The main aim of this quality improvement project is to improve care of patients with peri-prosthetic joint infections (PJI), by assuring appropriate diagnostics are sent and antibiotics recommended are as per Pro-Implant and British Orthopaedic association (BOA) guidelines, which are international and national guidelines. Method Retrospective analysis of all tissue samples received for patients with periprosthetic joint infections during August 2022 and August 2023 from patients across Manchester. There were 68 samples (17 patients) in total with peri-prosthetic joint infections out of 197 samples (62 patients). These were all compared to standards set by the Pro-Implant and BOA. Multiple criteria were compared by analysing clinic letters and Labcentre documentation. Results The results show a 100% compliance in discussion of PJI diagnosis with microbiologists, correctly labelling samples, and CRP analysis. However, we struggled with making diagnosis as per guidelines, sending more than 5 samples and discussing discharge antibiotic plans with microbiologists. Furthermore, we didn’t utilise sonification, PCR and histology to aid diagnosis. We also struggled with meeting the appropriate interval time between stages of two stage exchanges. Conclusions In conclusion, there is room for improvement in certain criteria’s’ as per the guidelines:Engagement with orthopaedic stakeholder to explore barriers to compliance.Dedicated MDT compromising of orthopaedic surgeons, infection doctors.Creation of an intraoperative pro-forma for suspected PJIs’ to act as a reminder to surgeons and allow clear documentation.Availability and awareness of guidelines to orthopaedic teamFunding for PCR, sonification and histopathologyJoint follow up clinic with microbiologist to improve patient follow up plans.