Improving compliance of wound photography in open fracture patients

Farhan-Alanie, Muhamed M.; Mackay, Nicola D.; Ward, Jayne King Richard

BackgroundFractures associated with skin wounds are termed open fractures. The British Orthopaedic Association Standards for Trauma guidelines on open fractures recommends photographing the patient’s wound prior to application of a temporary dressing. Access to these images prevents the need for clinicians to uncover and re-examine wounds which reduces the risk of infection.ProblemA retrospective audit revealed only 10% of open fracture patients’ records contained a wound photograph at our hospital. This was attributed to technical difficulties with existing hospital camera software applications and patient confidentiality issues preventing use of personal mobile devices.AimsWe aimed to develop a new process to improve compliance to wound photography in open fracture patients.Methods and resultsDuring the COVID-19 pandemic, Microsoft Teams became available for PC and mobile devices in our trust. A channel was set up in this software enabling secure sharing of photographs across devices. Photographs could be captured using a mobile phone without the image being saved on the device and then accessed through the PC software application. Images could then be transferred to patients’ electronic records and stored. A photography consent form was developed and stored using the same method. Details of this intervention were circulated via departmental and induction meetings. Our work demonstrates leadership qualities through setting a new direction to securely photograph and store images to improve patient care. Our management skills are demonstrated through organisation and administration of the channel. We are on Plan-Do-Study-Act (PDSA) cycle 1 and will shortly commence evaluation of our intervention.ConclusionsWe anticipate our intervention will gradually improve wound photography compliance in open fracture patients following continued PDSA cycles. Our devised photography process can be applied for other clinical indications within various specialities.