174 Audit of moving and handling documentation for patients with suspected metastatic spinal cord compression (MSCC)

<h3>Background and Intro</h3> Appropriate moving and handling (M&amp;H) recommendations for patients with suspected metastatic spinal cord compression (MSCC) reduces potential to cause harm by avoiding unsafe movement, especially with spinal instability. The aim was to identify ways of improving communication of M&amp;H advice within our Specialist Inpatient Palliative Care Units (PCU). <h3>Method</h3> Patients were identified by reviewing those who had an MRI request including the words ‘’MSCC’ and those who were an inpatient on the PCU during their admission. Data was taken over a 3-year period between January 2018-October 2021. A total of 28 patients notes were reviewed retrospectively against a five-question audit tool based upon Trust and NICE Guidelines. Interventions were put in place which aimed to improve practice, including education of nurses, physiotherapists, and doctors, along with aide memoires (covering the symptoms of and actions needed in suspected MSCC). Re-audit 36-months later identified a total of 31 patients who had an MRI for suspected MSCC and who were on a PCU, following the same method and review process, from October 2021-April 2024. <h3>Results</h3> During the initial audit, 86% of the notes suggested MSCC was suspected with only 11% having a M&amp;H recommendation documented for the wider team to follow. The re-audit shows 84% suspected MSCC with 20% having a M&amp;H recommendation clearly documented. <h3>Conclusion</h3> Documentation is required to recommend appropriate M&amp;H for all staff involved in patient care. The re-audit demonstrates slight improvements but remains below recommended standards. Ongoing education to consider spinal instability while managing MSCC is critical to prevent patient harm through inappropriate movement before definitive treatment. Although the audit did not set out to review outcomes when MSCC best practice guidance was not followed, no serious adverse events were identified during the process.