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Please confirm that an ethics committee approval has been applied for or granted: Yes: I’m uploading the Ethics Committee Approval as a PDF file with this abstract submissionApplication for ESRA Abstract PrizesBackground and Aims Enhanced recovery after surgery (ERAS) is an evidence-based protocol which is multimodal and multidisciplinary in nature and promotes faster recovery. Numerous studies have investigated the ERAS outcomes in orthopaedic joint surgeries and have concluded that they decrease length of hospital stay, decrease medical costs, decrease risk of post-operative complications and improve clinical outcomes. We decided to audit staff compliance in prescription of orthopaedic rapid recovery programme (RRP) drugs in the immediate recovery and post operative period following lower limb joint replacement surgery.Methods After gaining input from the acute pain team and audit supervisor an audit proforma was designed to gather relevant information. Data was collected over a period of 4 weeks by acute pain nurses on days 0 and 1 post-operatively. 44 patients were included in this audit and prescription of RRP drugs was audited against the local trust protocol.Results Statistics revealed significant non-compliance in prescription of post operative RRP drugs especially the long-acting opioids(61%) and the Anti-neuropathic agents(43%) with respect to dose timing and the number of doses prescribed and required frequent acute pain team intervention to correct it. 23% patients had no NSAID prescription without appropriate reasoning. DOAC prescription was inappropriate in 23% patients and 14% had no thromboprophylaxis prescribed.Conclusions One of the main obstacles in success of ERAS remains reduced compliance and deviation from the protocol by the providers. For ERAS to be practised successfully, practical strategies based on sufficient understanding of the ERAS components and their outcomes are essential. Re-audit will be done in 6 months.