Successful use of "Choice Architecture" and "Nudge Theory" in a quality improvement initiative of analgesia administration after Caesarean section.
Adult
Analgesics
/ therapeutic use
Australia
Cesarean Section
/ adverse effects
Female
Humans
Medication Therapy Management
/ standards
Pain Management
/ methods
Pain, Postoperative
/ diagnosis
Pregnancy
Prenatal Education
/ methods
Prescription Drug Overuse
/ prevention & control
Program Evaluation
Quality Improvement
clinical audit
clinical guidelines
evaluation
medical error
progress
Journal
Journal of evaluation in clinical practice
ISSN: 1365-2753
Titre abrégé: J Eval Clin Pract
Pays: England
ID NLM: 9609066
Informations de publication
Date de publication:
Feb 2019
Feb 2019
Historique:
received:
09
05
2018
revised:
06
08
2018
accepted:
13
08
2018
pubmed:
4
10
2018
medline:
27
4
2019
entrez:
4
10
2018
Statut:
ppublish
Résumé
Regular, routine, multimodal analgesia provides better pain relief following Caesarean section than reliance on "as required" opiate dosing. This quality improvement report describes the effective use of an education programme coupled with a highlighted, preprinted medication chart, employing "Nudge Theory" principles to achieve significant improvements in the administration of analgesic medications to patients after Caesarean section operations. An acute pain service audit identified a serious deficiency with delivery of regular postoperative analgesic medications to patients following Caesarean section operations. An audit of pain medication delivery to patients following Caesarean section demonstrated that postoperative analgesia was not being administered in line with local prescribing guidelines. Two interventions were planned: Education sessions for anaesthetic recovery and ward staff. Introduction of a new preprinted and highlighted medication chart. A postintervention audit was then conducted. There were statistically significant improvements in all medications administered to patients following the two interventions. For analgesic medications, the rate of administration of drugs in compliance with guidelines rose from 39.6% to 89.9% (P < 0.001 using 2-sample z test). Each subgroup of medications also showed statistically significant improvements in administration compliance. A combined approach, including application of "Nudge Theory" to the administration of analgesic medication after Caesarean section, considerably improved delivery of medications prescribed for postoperative analgesia.
Sections du résumé
BACKGROUND
BACKGROUND
Regular, routine, multimodal analgesia provides better pain relief following Caesarean section than reliance on "as required" opiate dosing. This quality improvement report describes the effective use of an education programme coupled with a highlighted, preprinted medication chart, employing "Nudge Theory" principles to achieve significant improvements in the administration of analgesic medications to patients after Caesarean section operations.
PROBLEM
OBJECTIVE
An acute pain service audit identified a serious deficiency with delivery of regular postoperative analgesic medications to patients following Caesarean section operations.
METHODS
METHODS
An audit of pain medication delivery to patients following Caesarean section demonstrated that postoperative analgesia was not being administered in line with local prescribing guidelines. Two interventions were planned: Education sessions for anaesthetic recovery and ward staff. Introduction of a new preprinted and highlighted medication chart. A postintervention audit was then conducted.
RESULTS
RESULTS
There were statistically significant improvements in all medications administered to patients following the two interventions. For analgesic medications, the rate of administration of drugs in compliance with guidelines rose from 39.6% to 89.9% (P < 0.001 using 2-sample z test). Each subgroup of medications also showed statistically significant improvements in administration compliance.
CONCLUSION
CONCLUSIONS
A combined approach, including application of "Nudge Theory" to the administration of analgesic medication after Caesarean section, considerably improved delivery of medications prescribed for postoperative analgesia.
Substances chimiques
Analgesics
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
125-129Informations de copyright
© 2018 John Wiley & Sons, Ltd.