EP.WE.406Adherence to operative standards for ulnar polydactyly excision in times of COVID-19 pandemic

Aims Simple ulnar polydactyly excision is a very common surgical procedure ideally performed within the first 6 months of infants life and under local anaesthetic. In conditions preceding COVID-19 pandemic this procedure was performed in controlled environment of operating theatres on a weekly basis. Increase in pressure on the NHS and operating theatre reorganisation meant elective procedures had to be cancelled with no alternatives in sight. We have suggested therefore, it be performed in a clinic environment instead under strict supervision and guidelines. No recommendations however, have been implemented when considering completion of WHO checklist and standard operation documentation. We investigated therefore adherence to typical Evelina Hospital theatre guidelines when considering documentation. Methods Completed documentation for each patient undergoing ulnar polydactyly excision in clinic room was reviewed between May 2020 and December 2020. Categories of WHO checklist completion, operation note present and legible, appropriate local anaesthetic information and instrument count correct were reviewed. Results 92% of procedures did not have WHO checklist completed. Furthermore, as many as two thirds of the documents were completed illegibly and did not contain required information. Conclusions Following the transfer of ulnar polydactyly excision procedure to clinic rooms we found the quality of documentation to be substandard. This provides opportunity for error and cause for concern. We introduced therefore standardised operative documentation pack to be completed at each polydactyly excision procedure in clinic room. Re-audited results showed improved compliance with standard operative rules and regulations and therefore improved quality of care.