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Aim Emergency laparotomy is a common procedure associated with high risk of mortality and morbidity. NELA risk score calculation for patients undergoing emergency laparotomy improves the quality of patient care and compares the organisation of patient care provided to the outcomes following surgery. The aim of this study was to determine if NELA score was calculated and documented pre-laparotomy. Methods A retrospective analysis was conducted for patients who had emergency laparotomy at a primary care hospital in England. This study included reviewing the case notes and consent forms to assess if NELA risk score was calculated. Following further education of the surgical team, the audit loop was closed.The primary outcome was to identify not only calculation but also that the score was documented. Results Measures taken to enhance NELA risk calculation included theatre co-ordinator asking for NELA risk score while booking for laparotomy and documentation on the booking form and posters on surgical ward. Consequently, 40% notes included Scoring which improved to 70% after making the above changes.  Conclusion The NELA risk score should be calculated for all patients undergoing emergency laparotomy as it estimates an individual’s risk of death within 30 days of surgery. It also standardises the risk calculation among all laparotomy patients and aids in clinical decision making, therefore is vital to be calculated in pre-operative phase. To ensure it is correctly calculated at all times, regular teaching and updates of NELA score is recommended.

EP.FRI.650 Are we calculating and documenting the NELA Score pre-operatively?