Drug administration can be improved by simple guidelines discussed by all staff affected

In the first of our Quality Improvement Reports Ripouteau et al describe how doctors and nurses on orthopaedic wards improve the efficiency of postoperative pain management by early switching from intravenous to oral acetaminophen (paracetamol), which is cheaper and just as effective (p 1461). A local guideline proposed switching to oral paracetamol once the patient could eat solid food. This was agreed by the prescribing anaesthetists, who wrote the instruction on patients' charts. All nurses underwent an hour's educational presentation, backed up by posters and feedback at six months. The mean number of injections per patient fell from 6.81 before the intervention to 2.36 six months after it. No change was seen in other surgical wards, which acted as controls.

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Relevant Article

Quality improvement report: Effect of multifaceted intervention promoting early switch from intravenous to oral acetaminophen for postoperative pain: controlled, prospective, before and after study

Claire Ripouteau, Ornella Conort, Jean Paul Lamas, Guy-Robert Auleley, Georges Hazebroucq, and Pierre Durieux
BMJ 2000 321: 1460-1463. [Abstract] [Full Text] [PDF]