858 Post Operative Opioid Prescribing in Patients Undergoing Primary Elective Total Hip Replacement (THR): A Closed-Loop Clinical Audit

Abstract Aim To assess departmental performance versus NICE NG180 recommendations for post operative analgesia in patients undergoing primary THR. Method Local databases were reviewed, and patients selected based on the following inclusion criteria:Elective patients undergoing Total Primary Hip ReplacementNo contraindications to oral intake.Aged 60+ The extracted data were as follows:Immediate post operative regular opioid prescribed on Day 0 (D0).Regular post operative opioid prescribed on D0?How many hours from end of surgery to receiving 1st oral opioid dose?Pain reported on D0 post operative.Pain reported on Day 1 (D1) post operatively. The initial loop involved data from May 2023-July 2023, with the second cycle reauditing based on data from collected from September 2023-November 2023 following implementation of printed posters of NICE NG180 and face to face education on post operative analgesia. Results In comparison to the first cycle of the audit, there has been a 30% increase in the number of purely regular oral opioid prescriptions on D0. A 10% increase in the number of patients receiving their oral opioid dose within 2 hours post operatively is seen between cycles in those with a regular opioid prescription. Whilst the 2-8 hour and 8-hour prescriptions remained at similar percentages for comparative patient sizes. Conclusions The interventions implemented after the first cycle have shown improvement in departmental performance. To better this further, we propose creating an electronic prescription order set to help clinicians appropriately manage post operative analgesia requirements in this patient group.