3464 A quality improvement project in managing AKI in post operative femur fracture and other orthopaedic patients

Abstract Introduction Acute Kidney Injury (AKI) is a serious and preventable complication in older adults following orthopaedic surgery. At Lincoln County Hospital, inconsistent AKI recognition and response led to a Quality Improvement Project (QIP) aiming to embed the trust’s AKI bundle into routine postoperative care. Method A prospective, two-cycle audit was conducted on orthopaedic postoperative patients. Patient records and electronic data were reviewed for AKI recognition, management, and outcomes. Between cycles, interventions included targeted teaching sessions, visual reminders across wards, and the introduction of a structured AKI assessment proforma. Results Initial audit findings revealed only 20% adherence to the AKI care bundle. Following intervention, compliance rose to 100% in the second cycle. Clinician engagement with medication review and fluid assessments improved significantly, leading to earlier detection and fewer AKI cases. The project was presented at the hospital’s Clinical Governance Meeting, where it was well received and subsequently integrated into the junior doctors’ induction programme. It was also showcased at a regional quality improvement conference. Conclusion This QIP demonstrates that low-cost, high-impact interventions—driven by education, visibility, and practical tools—can dramatically improve AKI management in orthopaedic patients. By embedding these changes into routine practice and institutional teaching, we’ve established a sustainable, replicable model for improving postoperative outcomes in older adults.