BG06 Emollient prescribing in perioperative patients aged > 65 years

Abstract Perioperative patients aged ≥ 65 years may experience compromised skin integrity due to surgical stress, anaesthesia and postoperative conditions. This can increase their risk of pruritus, dermatitis and surgical-site infections. Despite this, emollient prescribing practices during hospital admissions remain inconsistent. This audit aimed to evaluate emollient prescribing practices for perioperative patients aged ≥ 65 years, to assess adherence to guidelines, and to identify opportunities for improvement. Data were collected from 56 patients over a 3-week period on an orthopaedic ward. Patients were included if they were aged ≥ 65 years and in the pre- or postoperative phase. Prescribing practices were evaluated against National Institute for Health and Care Excellence guidelines. Collection involved reviewing patients’ Summary Care Records (SCRs) to identify regular emollient prescriptions; assessing whether medications were appropriately documented on inpatient drug charts; and identifying any delays in prescription. The type of emollient prescribed and its frequency of application were also recorded. Simultaneous skin assessments documented conditions such as dryness and pruritus. All data were systematically recorded and organized in Microsoft Excel for analysis. An intervention, in the form of a poster campaign, was introduced to remind clinicians to review SCRs for regular emollient prescriptions, ensure these were transcribed onto inpatient drug charts, assess patients’ skin during examination, and prescribe emollients as appropriate. A follow-up data collection period, involving 49 patients, was conducted to evaluate the impact of the intervention. The initial data revealed that 32 (57%) of the 56 patients had a regular emollient prescription documented on their SCR, and 19 (59%) of these had the emollient transcribed onto their inpatient drug chart at admission. No new emollient prescriptions were initiated during this period. Skin assessments identified common conditions among patients, including dryness (25%), eczema (34%), pruritus and sore skin. The types of emollients prescribed varied. The frequency of application also varied: 54% were prescribed on an ‘as required’ basis, while 46% had specific instructions to apply. Following the poster intervention, 49 patients were assessed. Among these, 21 (43%) had regular emollient prescriptions documented on their SCR, with 13 (62%) of these prescriptions transcribed onto their inpatient drug chart. The audit demonstrated that while some perioperative patients receive emollient prescriptions, significant gaps remain, particularly in timely and consistent documentation on drug charts. This intervention increased awareness but had limited impact, highlighting the need for more robust strategies. Recommendations include integrating emollient prescribing guidelines into ward protocols, enhancing staff education, and conducting regular audits to ensure adherence and improve patient care outcomes.