P58
CHANGING PRACTICE WITH A SIMPLE STICKER: REDUCTION OF INTRAOPERATIVE INTRAVENOUS PARACETAMOL ADMINISTRATION
S. Bailey, Queen Victoria Hospital NHS Trust, East Grinstead, UK
Paracetamol is a safe and effective analgesic used commonly in paediatric day surgery. It can be given preoperatively via the oral route or can be administered whilst under anaesthesia intravenously.
Using the intravenous route offers no analgesic benefit, has greater potential for drug error and has higher cost and environmental impact.
The aim of this QIP was to increase oral paracetamol administration to paediatric patients pre-operatively by the introduction of a pre-medication sticker, and thereby reduce the amount of intravenous paracetamol administered.
The use of a sticker simplifies the process, empowering the nursing staff to approach anaesthetists to sign the sticker, making the prescription and administration an easier more streamlined process.
Method:
Stage 1:
We reviewed paediatric (12m-16y) patient drug charts attending for surgery on paediatric ward over a 1-week period to understand how paracetamol is prescribed and administered.
Stage 2:
Introduction of a sticker - pre-printed paracetamol doses (for age) which was stuck on the front of the drug chart. We discussed and informed all anaesthetists and paediatric nursing staff of the sticker for use pre-operatively.
Stage 3:
Re-review of paediatric patient drug charts to see how this intervention has changed practice.
Results
Round 1
Number of cases – 38
- Pre-op oral paracetamol 2 (5%)
- Intra-op IV paracetamol 22 (58%)
Round 3
Number of cases - 35
- Pre-op oral paracetamol 22 (63%)
- Intra-op IV paracetamol 3 (9%)
Conclusion
A simple intervention has shown a significant decrease in IV paracetamol administered. This will lead to positive cost and environmental impacts at QVH.
References:
A systematic review and trial sequential analysis of intravenous vs. oral peri-operative paracetamol.
Mallama M, Valencia A, Rijs K, Rietdijk WJR, Klimek M, Calvache JA.
Anaesthesia. 2021 Feb;76(2):270-276.
Oral, in place of intravenous, paracetamol as the new normal for elective cases
- Myo, S. Pooley, F. Brennan
Anaesthesia · Volume 76, Issue 8 p. 1143-1144