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Related Experiment Videos

Paracetamol pro re nata orders: an audit.

S A Lamb1, R L Henry

  • 1Royal Aberdeen Children's Hospital, Aberdeen, New South Wales, Australia.

Journal of Paediatrics and Child Health
|March 11, 2004
PubMed
Summary
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Physician prescribing of paracetamol (acetaminophen) often lacks clear indications, leading to miscommunication with nurses and inconsistent administration. This highlights a systemic issue in hospital medication practices requiring clearer guidelines for effective pain management.

Area of Science:

  • Pediatric Pharmacology
  • Hospital Pharmacy Practice
  • Evidence-Based Medicine

Background:

  • Paracetamol (acetaminophen) is a common analgesic in hospitals.
  • Physician prescribing practices for paracetamol, particularly pro re nata (PRN), are not well understood.
  • Variability in prescribing and administration can impact patient care.

Purpose of the Study:

  • To compare physician prescribing habits for PRN paracetamol with nursing interpretation and evidence-based guidelines.
  • To identify discrepancies in the understanding and application of paracetamol orders.
  • To evaluate the clarity and consistency of paracetamol prescribing in pediatric care.

Main Methods:

  • Retrospective chart review of 313 children's records.
  • Audit of 100 children with PRN paracetamol orders to assess written indications.

Related Experiment Videos

  • Interviews with physicians and nurses regarding intended and actual administration of paracetamol.
  • Comparison of clinical practices with hospital guidelines.

    • Main Results:

    • Seventy-four percent of charts contained paracetamol orders.
    • Only one physician provided written indications for paracetamol administration.
    • Frequent miscommunications occurred between physicians and nurses regarding paracetamol orders.
    • Nurses administered paracetamol at lower temperatures than intended by physicians.
    • Significant variations in interpretation existed among healthcare professionals.

    Conclusions:

    • Observed idiosyncratic ordering and administration of paracetamol suggests a systemic issue.
    • There is a need for more objective indications for paracetamol use.
    • Medical staff require clearer communication and explicit meaning in medication orders.