100 Weightbearing Status Documentation in Orthopaedic Operation Notes – A Snapshot Audit

This is the authors' abstract. We don't add key points for this paper.

Aim A snapshot audit was performed to assess current compliance with the most recent guidelines on weightbearing documentation in accordance with British Orthopaedic Association Standards (BOAST). Weight-bearing terminology has been shown to be ambiguous and is often understood variably by both healthcare professionals and patients. Standardisation of terms has been suggested to reduce confusion for patients and therapy teams during rehabilitation following surgery. Method A single-centre retrospective audit of 50 lower-limb operation notes (25 trauma; 25 elective) from electronic patient records to correct weightbearing terminology use and documentation of mobilisation limitations following surgery in accordance with BOAST guidelines. After baseline measurement and consultation with physiotherapists, educational interventions were implemented for surgeons including theatre posters, template training and reminder messages via WhatsApp groups. A target of 80% compliance was set. Results The baseline audit showed 6% compliance (for “non-weightbearing” cases only) with significant variability in terminology used. None of the cases in which patients were limited or non-weightbearing had rationale given for this. Functional and duration limitations were given for 60% and 86% of cases respectively. Conclusions It is evident that knowledge on the changes in recommended weightbearing terminology is severely lacking. Simple educational methods and use of a template can invariably improve compliance with this. This particular topic promotes interdisciplinary working among therapy colleagues who have a vested interest in the timely rehabilitation of postoperative patients, accurate to surgeon preferences. A series of rapid-cycle audits are currently underway to review the impact of these interventions.