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A closed-loop audit evaluated current NV documentation against the December 2021 British Orthopaedic Association Standards for Trauma (BOAST) and tested whether targeted education could improve compliance. The study compared two audit cycles after an educational presentation in May 2024, using BOAST-aligned criteria to assess neurological and vascular recording.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/improving-patient-care-and-clinical-services-compliance-with-boast-guidelines-for-neurological-and-vascular-assessment-of-acute-fractures/433228/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/improving-patient-care-and-clinical-services-compliance-with-boast-guidelines-for-neurological-and-vascular-assessment-of-acute-fractures/433228.png","ImageObject",300,407,{"name":92,"@type":93},"nayy☆","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-07","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":52},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"Why is neurovascular (NV) documentation essential in acute fractures?","Question",{"text":112,"@type":113},"Traumatic limb injuries can lead to NV compromise. BOAST requires documented, nerve-specific sensory and motor assessment and arterial status after injury, manipulation, cast fitting, or surgery to support early detection and management.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How was compliance measured in the study?",{"text":117,"@type":113},"The audit reviewed 97 adult acute upper- or lower-limb fracture admissions across two cycles and extracted data from trauma & orthopaedic admission notes. Documentation was benchmarked against BOAST criteria requiring specific nerve and arterial status.",{"name":119,"@type":110,"acceptedAnswer":120},"What impact did the educational intervention have on NV recording?",{"text":121,"@type":113},"NV documentation increased from 87.8% to 97.9% after the intervention. Vascular details improved significantly (26.5% to 45.8%), while detailed neurological recording rose modestly (38.8% to 54.2%).","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},433228,1790749500,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":52,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":24,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":144,"preview_page_count":4},962090893153,"https://ap-avatar.wpscdn.com/davatar_9964176cb1d06d4a9deccf72a44ae3dc","Review began 11/11/2025  \nReview ended 11/26/2025  \nPublished 12/04/2025  \n© Copyright 2025  \nMussab et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0. , which permits unrestricted use , distribution , and reproduction in any medium , provided the original author and source are credited.  \nDOI: 10.7759/cureus.98439  \nOpen Access Original Article  \nImproving Patient Care and Clinical Services: Compliance With the British Orthopaedic Association Standards for Trauma (BOAST) Guidelines for Neurological and Vascular Assessment of Acute Fractures  \nRaja Muhammad Mussab 1, 2, Irfan Ahmad 2, Rida Sohail 2, Tassreena Jahan Jany 2, Vishnu Raja Anil Kumar 2  \n1. Orthopaedics and Trauma, Jinnah Postgraduate Medical Centre, Karachi, PAK 2. Orthopaedics and Trauma, Russell Hall Hospital, Dudley, GBR  \nCorresponding author: Raja Muhammad Mussab, [mussabafaq@hotmail.com](mussabafaq@hotmail.com)  \nAbstract  \nIntroduction  \nTraumatic limb fractures risk neurovascular (NV) compromise and require documented nerve-specific sensory, motor, and arterial assessments to support early detection and management. The British Orthopaedic Association Standards for Trauma (BOAST) mandate clear documentation of peripheral nerve function after injury, manipulation, cast fitting or surgery. This closed-loop audit measured current practice against the December 2021 BOAST guideline and tested whether a targeted educational intervention could improve NV documentation.  \nMethods  \nAn audit for service evaluation and quality improvement at Russell Hall Hospital, UK, reviewed 97 adults admitted with acute upper-or lower-limb fractures across two cycles (49 patients, January 2024; 48 patients, July 2024) . A single educational awareness presentation took place in May 2024. Data were extracted from Trauma & Orthopaedic (T &O) admission notes and benchmarked against BOAST criteria requiring specific nerve and arterial status. Median age and interquartile range (IQR) were reported ; categorical comparisons used Pearson’s χ², and effect size was reported as phi (φ) . Significance threshold was p \u003C 0.05.  \nResults  \nMedian age was 64 years (IQR: 34.5-79.5) . The use of NV documentation rose from 87.8% to 97.9% following the intervention (χ² = 3.74, df = 1 ; p = 0 .053) . Detailed neurological recording increased from 38.8% to 54.2%(χ² = 2 .31, p = 0 .129; φ = 0 . 154) . Detailed vascular recording improved from 26.5% to 45.8%, reaching statistical significance (χ² = 3 .92, p = 0 .048; φ = 0 .201) . Many entries continued to use the nonspecific phrase'NV intact ' rather than specific details.  \nConclusion  \nEducational sessions within a closed-loop audit framework improved completion of an NV assessment and a significant rise in vascular details, while neurological details showed a slight increase. Continued adherence to BOAST guidance and structured feedback mechanisms should preserve high standards of NV assessment and improve patient safety.  \nCategories: Neurology, Trauma, Orthopedics  \nKeywords: clincal audit, clinical examination, neurological examination, quality improvement and patient safety,  \nvascular examination  \nIntroduction  \nTraumatic musculoskeletal injuries of the upper and lower limbs are common in acute hospital settings, yet their consequences extend beyond bony fractures to include potential neurovascular (NV) compromise [1] . A comprehensive neurological and vascular assessment of any injured limb is a central component of initial assessment and subsequent care. Thorough documentation of nerve-specific sensory and motor function  \nand arterial status is essential to detect early neuropathic or vascular injury [2] . British Orthopaedic Association Standards for Trauma (BOAST) requires that a full assessment of all relevant peripheral nerve functions be performed and clearly documented as soon as possible after injury, manipulation, cast fitting, or surgery [3] . Despite this guidanc","cbCaikKNI2sbEN2e","https://ap.wps.com/l/cbCaikKNI2sbEN2e","pdf",132355,"English","# Abstract\n## Introduction\n## Methods\n## Results\n## Conclusion\n## How to cite this article\n## Materials And Methods","[{\"question\":\"Why is neurovascular (NV) documentation essential in acute fractures?\",\"answer\":\"Traumatic limb injuries can lead to NV compromise. BOAST requires documented, nerve-specific sensory and motor assessment and arterial status after injury, manipulation, cast fitting, or surgery to support early detection and management.\"},{\"question\":\"How was compliance measured in the study?\",\"answer\":\"The audit reviewed 97 adult acute upper- or lower-limb fracture admissions across two cycles and extracted data from trauma \\u0026 orthopaedic admission notes. Documentation was benchmarked against BOAST criteria requiring specific nerve and arterial status.\"},{\"question\":\"What impact did the educational intervention have on NV recording?\",\"answer\":\"NV documentation increased from 87.8% to 97.9% after the intervention. Vascular details improved significantly (26.5% to 45.8%), while detailed neurological recording rose modestly (38.8% to 54.2%).\"}]","Improving Patient Care and Clinical Services - Compliance With the British Orthopaedic Association Standards for Trauma (BOAST) Guidelines for Neurological and Vascular Assessment of Acute Fractures | PDF",1790663214,13]