The project consisted of three phases:
^ • A pre-intervention case note audit looking
j at the method of detoxification, the drugs
S used and the time taken to detox, to assess
Box I. Audit tool And rationale for questions
Was the alcoiiol ICP used in the management of this patient?
Important to identify if the trust guidelines are being met
Number of days to compiete detox?
Important to compare pre-ICP and post-ICP to note any improvement
How much chlordiazepoxide was administered?
Important to compare pre-ICP and post-ICP to note any improvement
If ICP not started, was PRN medication used?
This will identify if predetermined dosing regimes are used and whether staff are trying to alleviate
further symptoms with as-required medication
If PRN medication was used, was the reason identified in the notes?
This will highlight the need for CIWA scoring system that is part of ICP to improve assessment and
documentation
What drug is used in the detox process?
Will see if we are using the best available pharmacology to manage this group
Is there consistency with prescribing?
Are the medicines prescribed in proper place?
Are aii areas of the prescription chart compiete?
This will identify any problems with medical prescribing
Did anyone deveiop deiirium or seizure activity after starting on a detox?
This will help identify differences between symptom-triggered management and predetermined
dosing
the extent of variation in treatment across
the hospital
• The development and implementation
of an evidence-based, symptom-triggered
protocol for the management of detox,
along with the education of all staff groups
• A post-intervention case note audit
to assess the effects of the changes on
treatment regimes and the care of patients.
A questionnaire was also used at this stage
to gauge staff satisfaction with the change.
The project consisted of three phases:^ • A pre-intervention case note audit lookingj at the method of detoxification, the drugsS used and the time taken to detox, to assessBox I. Audit tool And rationale for questionsWas the alcoiiol ICP used in the management of this patient?Important to identify if the trust guidelines are being metNumber of days to compiete detox?Important to compare pre-ICP and post-ICP to note any improvementHow much chlordiazepoxide was administered?Important to compare pre-ICP and post-ICP to note any improvementIf ICP not started, was PRN medication used?This will identify if predetermined dosing regimes are used and whether staff are trying to alleviatefurther symptoms with as-required medicationIf PRN medication was used, was the reason identified in the notes?This will highlight the need for CIWA scoring system that is part of ICP to improve assessment anddocumentationWhat drug is used in the detox process?Will see if we are using the best available pharmacology to manage this groupIs there consistency with prescribing?Are the medicines prescribed in proper place?Are aii areas of the prescription chart compiete?This will identify any problems with medical prescribingDid anyone deveiop deiirium or seizure activity after starting on a detox?This will help identify differences between symptom-triggered management and predetermineddosingthe extent of variation in treatment acrossthe hospital• The development and implementationof an evidence-based, symptom-triggeredprotocol for the management of detox,along with the education of all staff groups• A post-intervention case note auditto assess the effects of the changes ontreatment regimes and the care of patients.A questionnaire was also used at this stageto gauge staff satisfaction with the change.
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