Pethidine prescribing in the ED… Let’s be rational! Kaye KI, Maxwell DJ, Graudins L, on behalf of the the NSW Therapeutic Assessment Group (NSW TAG) Drug.

Slides:



Advertisements
Similar presentations
Medication Management
Advertisements

Division of Mental Health and Addiction Services Office of Care Management March 14, 2013.
Update: AHEAD Asthma Protocol QI Project Presented by: Katie Loveland, MPH, MSW.
Bree Collaborative Cardiology Report: Appropriateness of Percutaneous Cardiac Interventions (PCI) Bree Collaborative Meeting November 30, 2012.
Questions or comments on this presentation can be addressed to You can pick and choose the elements.
Improving Analgesia in Emergency Departments: Optimising Use of Pethidine A Multi-centre DUE Project Coordinated by NSW Therapeutic Assessment Group Funded.
Emergency Unit Management: a guide to better practice Basil Bonner Head: Emergency Unit Milnerton Medi-Clinic.
Clinical Audit How to make it work Clinical Audit Department Last revised July 2009.
Development of Clinical Pathways to Streamline Care for Patients Presenting with Suspected Cardiac Chest Pain Background The National Heart Foundation.
WHAT IS CQI? Contact the CQI Committee: (360)
Pethidine: Gap Between Evidence and Practice Professor Richard Day Dept of Clinical Pharmacology and Toxicology St Vincent’s Hospital, Sydney Prepared.
Implementation of local guideline by interactive workshop improves anticoagulation therapy and patient safety Puhakka J, Helsinki Health Centre, GP Suvanto.
A collaborative approach to facilitating evidence-based practice in the Bradford and Airedale NHS community Caroline Storer Rebecca Williams Andy Arnfield.
VERMONT Results of the GO PROSPER Survey Round 1, Fall 2010 PROmoting School-community-university Partnerships to Enhance Resilience.
Health Promoting Health Service: Development day.
Improving Analgesia in Emergency Departments: Optimising Use of Pethidine A Multi-centre DUE Project Coordinated by NSW Therapeutic Assessment Group Funded.
IMPROVING DIABETES MANAGEMENT IN PRIMARY CARE
The Prescription Behavior Surveillance System: Applications of De-identified PDMP Data in Public Health Surveillance Rx Abuse Summit April 23, 2014 Peter.
The Role Of The Dementia Care Home Liaison Nurse Within South East Essex Jackie Smith Clinical Nurse Specialist Dementia Care Home Liaison Nurse.
Increasing Pharmacists reporting of adverse medication incidents Being Ready for new risks and Opportunities Prepared by Tim Garrett Northern Sydney Central.
Improving Analgesia: Farewell to Pethidine A Multi-centre DUE Project Susie Welch B.Pharm Project Officer, NSW TAG ED Pharmacist, St Vincent’s Hospital,
Power B, McQuoid P, Caldwell NA, Clareburt A. Pharmacy Department, Wirral Hospital NHS Trust, Wirral. Poster Layout & Design By Wirral Medical Illustration.
Improving Analgesia in Emergency Departments: Optimising Use of Pethidine A Multi-centre DUE Project Coordinated by NSW Therapeutic Assessment Group Funded.
 Established to: ◦ Increase recruitment of new members ◦ Maintain + retain current membership ◦ Provide guidance to chapter leadership ◦ Improve services.
Kelli Ham, Consumer Health Coordinator National Network of Libraries of Medicine, Pacific Southwest Region.
QUM Indicator 5.3 A Quality Improvement Program Ensuring explanations for changes to medication therapy in the discharge summary Presenter Insert your.
Organization and guideline development April 2010 ACCC The Netherlands.
The 5x5 Antimicrobial Audit is a component of the QUAH Antimicrobial Stewardship Toolkit Based on Prescribing Indicators developed by the Scottish Antimicrobial.
IMPACT OF AN ESSENTIAL DRUGS LIST AND TREATMENT GUIDELINES ON PRESCRIBING IN SOUTH AFRICA In 1998 the National Department of Health (NDOH) published standard.
University of Wisconsin Pain & Policy Studies Group World Health Organization Collaborating Center for Pain Policy and Palliative Care Action Plan for:
ABSTRACT Title: Developing National Formularies Based on the WHO Model Formulary Authors: Tisocki K 3, Laing RL 1, Hogerzeil H 1, Mehta DK 2, Ryan RSM.
Origin and Process of Utah Guidelines Anna Fondario, MPH Utah Department of Health Violence and Injury Prevention Program.
NICE - in evidence based commissioning Gateshead Council Gillian Mathews, Implementation Consultant - North 9 September 2011.
Abstract ID: 395 Author Name: Araya Sripairoj Presenter Name: Araya Sripairoj Authors: Sripairoj A, Liamputtong P, Harvey K.
IHI Methodology – Is it really a breakthrough? Kaye KI, Maxwell DJ, Graudins L, on behalf of the NSW Therapeutic Assessment Group (NSW TAG) Drug Use Evaluation.
Using drug use evaluation (DUE) to optimise analgesic prescribing in emergency departments (EDs) Karen Kaye, Susie Welch. NSW Therapeutic Advisory Group*
(MEDICAL) CLINICAL AUDIT
Understanding Monitoring & Indicators. What is Monitoring?  A continuing function that uses systematic collection of data on specified indicators to.
Summary Pattern of Specific COX II Inhibitors Use Physician prescribed appropriate COX II use in high risk was 40.08% and inappropriate COX II use in low.
A COMPARISON OF PRESCRIBING PRACTICES BETWEEN PUBLIC AND PRIVATE SECTOR PHYSICIANS IN UGANDA Obua C, Ogwal-Okeng JW, WaakoP, Aupont O, Ross-Degnan D International.
Large numbers of ill people seek care; EDs, clinics, and medical offices are crowded; there’s a surge on medical facilities; Delays in seeing a provider;
Diagnostic reference levels in Medical Imaging. Concept and practice
WHO PRESCRIBING INDICATORS (1991 – 1995) TRENDS AND PERSPECTIVES IN AN OUTPATIENT HEALTH CARE FACILITY IN BENIN CITY, NIGERIA. 1 Isah AO, 2 Isah EC, 3.
1 Session 14. Getting Started Drug and Therapeutics Committee.
DEVELOPING NATIONAL FORMULARIES BASED ON THE WHO MODEL FORMULARY Tisocki K, Laing RL, Hogerzeil H, Mehta DK, Ryan RSM.
How the Clinical Effectiveness Team can help you to audit your Prescribing Practice Jude Scott Clinical Governance & Risk Management Unit Clinical Effectiveness.
STUDY RESOURCES 1. OVERVIEW OF STUDY RESOURCES Study documents Study overview documents (project overview, data requirements.
Training for organisations participating in Peer Review of Paediatric Diabetes.
Clinical Documentation Pharmacy Department Dale Tucker, RPh, BCPS Harper University Hospital Hutzel Women’s Hospital Karmanos Cancer Hospital Rehabilitation.
WP7Joint and sustainable transport in health and care Action plan for the period July-December Dr Snežana Manić AdriHealthMob, Steering Committee.
V April 2016 Training Guide 1 NOTE: All screen shots from Communicare indicate PCEHR. Any reference to the PCEHR or the My Health Record within this.
Private and confidential Community Pharmacy Future Four-or-more medicines support service Update on progress and next steps Approved18 th June 2012 This.
An Audit to Determine if Prescribers are Reviewing Antimicrobial Prescriptions Hours After Initiation. Natalie Holman, Emma Cramp, Joy Baruah Hinchingbrooke.
Drug Utilization Review & Drug Utilization Evaluation: An Overview
Surgical antibiotic prophylaxis at Moi Teaching & Referral Hospital Rose Kakai 1, Barrack Ayumba 2, Damaris Lagat 2, Eveline Wesangula 3, Sam Kariuki 4.
Antibiotics: handle with care!
Comments to the FDA on Conditions of Safe Use To Expand Which Drug Products Can Be Considered Nonprescription Marissa Schlaifer, RPh Director of Pharmacy.
Evaluating Australia‘s National Strategy for Quality Use of Medicines
Pharmacy and Therapeutics Committees in Thai Hospitals under Health Reform Sripairoj A, Liamputtong P, Harvey K La Trobe University, Australia.
Introduction to Clinical Pharmacy
ABSTRACT Problem statement: The Lao PDR National Drug Policy (NDP) Program, implemented by the Ministry of Health supported by the Swedish International.
Comments to the FDA on Conditions of Safe Use To Expand Which Drug Products Can Be Considered Nonprescription Marissa Schlaifer, RPh Director of Pharmacy.
Clinical audit 2017/18 National Results
Clinical audit 2017/18 National Results
Abstract Impact of the National Healthcare Reform on Prescribing Patterns of Promotional Targeted Drugs among Thai Physicians Layton MR*, Chadbunchachai.
NSW TAG Pethidine in ED Project
Pharmacy practice and the healthcare system Ola Ali Nassr
Toktobaeva B, Karymbaeva S Drug Information Centre Kyrgyzstan
8 Medication Errors and Prevention.
Behavioral Health Identification, Treatment & Referral in Primary Care
Presentation transcript:

Pethidine prescribing in the ED… Let’s be rational! Kaye KI, Maxwell DJ, Graudins L, on behalf of the the NSW Therapeutic Assessment Group (NSW TAG) Drug Use Evaluation (DUE) Support Group, PO Box 766 Darlinghurst NSW 2010 INTRODUCTION 15 hospitals in the TAG network are participating. DUE methodology will be used to facilitate data collection, evaluation of data against agreed standards, feedback of evaluated data and targeted intervention. Over a 12-month period, multiple DUE cycles will be implemented in each participating hospital, the first scheduled for January A steering committee has been convened to provide advice for development of feedback reports, educational materials and mechanisms for on-going sustainability of the program. Each hospital has nominated a project coordinator who is responsible for liaison with ED staff and hospital committees. They are also coordinating data collection and feedback programs in their hospital. NSW TAG will provide information and support to hospital coordinators to facilitate these processes. Hospital coordinators will record the number of patients receiving pethidine in the ED (from existing Schedule 8 drug registers) and indications for that use. Stock issues from pharmacy for a range of analgesics will also be recorded. A feedback summary will be prepared by each hospital coordinator using a format prepared by NSW TAG. Prescribing patterns will be compared with evidence-based guidelines and areas of non-concordance highlighted. Feedback will be distributed to the ED Director, individual prescribers and the hospital Drug Committee. Targeted educational interventions will be introduced to promote rational prescribing. OBJECTIVE FURTHER INFORMATION Pain management is an ongoing area of interest for NSW TAG. In 1998 NSW TAG produced guidelines for rational use of opioids for GPs Prescribing for Pain in Migraine and Low Back Pain. These are currently being revised and updated. NSW TAG has also produced guidance documents on the use of newer analgesics in hospitals, including COX-2 inhibitors and tramadol. These documents can be downloaded from the NSW TAG web site. Pain management in hospital emergency departments (EDs) is a topical issue. The ongoing use of pethidine in EDs is of concern. Despite its limitations (Figure 1), pethidine is still widely used in hospitals. A recent survey of 18 NSW hospitals showed that a significant proportion of pethidine prescribing occurred in Emergency Department (Table 1) To increase awareness of the appropriate place for pethidine in pain management and to optimise pethidine prescribing by implementing a simple, ongoing DUE process in hospital EDs. NSW TAG is an initiative of NSW clinical pharmacologists and pharmacists, funded by the NSW Health Department. For more information about the NSW TAG network, visit our web site at THE PROBLEM WITH PETHIDINE [ i] [ i] Pethidine has a shorter duration of action than morphine with no additional analgesic benefit Pethidine has just as many side-effects as morphine (including bronchospasm and increased biliary pressure) Pethidine is metabolised to norpethidine, which has potential toxic effects (eg convulsions), especially in patients with renal dysfunction, Pethidine is associated with potentially serious interactions in combination with other drugs. Because of its euphoric effects: Pethidine is the drug most commonly requested by patients seeking opioids, and Pethidine is the drug most commonly abused by health professionals. [i][i] National Health and Medical Research Council. Acute pain management: scientific evidence, Commonwealth of Australia, 1999 METHODS Table 1 Pethidine usage TAG/TAGNet hospitals July-Sept 2001 This study is funded by a grant from the National Institute for Clinical Studies For further information about the Pethidine in ED Project contact the NSW Therapeutic Assessment Group Phone: Figure 1