Early fascia iliaca block documentation in hip-fracture care: A retrospective perioperative pathway audit

Fascia iliaca block is recommended as part of multimodal analgesia for patients with hip fracture, but early delivery and timestamped documentation are difficult to confirm in routine practice. This retrospective clinical audit assessed whether early delivery could be demonstrated from routine documentation in an operative hip-fracture pathway. The primary audit measure was fascia iliaca block documented within 2 h of emergency department arrival; exploratory outcomes included 48-h oral morphine equivalent dose, postoperative delirium, 30-day mortality and length of stay. Of 204 analysable episodes, 13 (6.4%; 95% confidence interval 3.8% to 10.6%) had fascia iliaca block documented within 2 h. A further 155 of 359 cleaned operative episodes (43.2%) had no recorded fascia iliaca block timing category. Exploratory outcome comparisons were underpowered because the early-delivery group was small. The findings identify a practical perioperative documentation and pathway gap requiring targeted improvement, mandatory timestamped recording and repeat audit.