Results of pre-implementation audit
The average number of days to detox a patient
was 6.36. On average it costs /Í300 per night
for an inpatient stay, making the average cost
of these detox attempts /^l908. The average
dose of chlordiazepoxide to complete an
inpatient detox was 563.3 mg. Forty percent
of patients were given PRN (when required)
medication, but in only 10% of these (two
patients) was the reason documented. Six of
the prescriptions did not use chlordiazepoxide
but other medication.
There were a number of prescribing errors,
such as:
• Dosing regimens prescribed in the wrong
area of prescription chart
• No maximal dose entered on chart
Tapering doses that increased instead ot
decreased
• Prescriptions that had fixed doses for a
number of days instead of decreasing
• Only PRN medication written, with no
guidance on administration
• Four prescriptions had fixed dosing, so
there was no reduction, which is needed in
withdrawal treatment.
There was great variation in the prescribing
methods used when reducing chlordiazepoxide
and in the number of days to complete a
detox (4 to 10). Most importantly, a total of
11 patients developed signs of severe AWS: 5
developed delirium tremens and 6 had postadmission
seizures.
Results of pre-implementation audit
The average number of days to detox a patient
was 6.36. On average it costs /Í300 per night
for an inpatient stay, making the average cost
of these detox attempts /^l908. The average
dose of chlordiazepoxide to complete an
inpatient detox was 563.3 mg. Forty percent
of patients were given PRN (when required)
medication, but in only 10% of these (two
patients) was the reason documented. Six of
the prescriptions did not use chlordiazepoxide
but other medication.
There were a number of prescribing errors,
such as:
• Dosing regimens prescribed in the wrong
area of prescription chart
• No maximal dose entered on chart
Tapering doses that increased instead ot
decreased
• Prescriptions that had fixed doses for a
number of days instead of decreasing
• Only PRN medication written, with no
guidance on administration
• Four prescriptions had fixed dosing, so
there was no reduction, which is needed in
withdrawal treatment.
There was great variation in the prescribing
methods used when reducing chlordiazepoxide
and in the number of days to complete a
detox (4 to 10). Most importantly, a total of
11 patients developed signs of severe AWS: 5
developed delirium tremens and 6 had postadmission
seizures.
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