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Ankle Injuries
Clinical scenario
Ankle injuries are common presentations to the Emergency Department, and a number of clinical decisions need to be made in order to manage these patients correctly, and these decisions should be evidence based. Correct management and disposal can also influence outcome in these patients.
Audit question
Are ankle injuires managed appropriately according to best practice guidelines?
Method
Retrospective audit
Sample: 30-50 Emergency Department patient records
Criteria
Inclusions: Patients with ankle injuries aged 16 years or over
Exclusions: Patients presenting with another medical condition.
Audits
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1st April 2009
Results
| Date | Patients | Measured | Results | Standard | Regional avg. |
|---|---|---|---|---|---|
| 01st April 2009 | Patients attending the ED with ankle injuries | Management of patients according to the criteria | Ottawa rules applied and documented | 100 % | 69.5 % |
| Time of manipulation recorded, if applicable | 100 % | 75 % | |||
| Pain score documented | 100 % | 45.2 % | |||
| Appropriate analgesia offered if applicable | 100 % | 80.5 % | |||
| If Ottawa rules negative, no x-ray | 100 % | 56.633 % |
Comments
There has been a reduction in the number of unnecessary x-rays, and better use of analgesia and the Ottawa rules. However documentation of pain score and time of manipulation are disappointing.
Audit Bottom Line
More improvments required across the board, in particular documentation, and further reduction in unnecessary xrays.