Using clinical governance to standardise an epidural service

Continual epidural infusions are an accepted intervention for the management of postoperative pain (McQuay and Moore 1998). Benchmarking nationally through an unpublished audit of Pain Society members identified variation in the concentrations prescribed and delivery systems used. These differences were reflected in local practice. As a result of the local disparity in the management and provision of epidural infusions, the acute pain service at Southampton University Hospitals NHS Trust worked in conjunction with the pharmacy department to standardise the service provided to patients and staff. This process was complicated by the difficulty in obtaining anaesthetist consensus for a standard solution that was commercially available and funding for the dedicated delivery system.