Electronic intravenous N-acetyl cysteine ordering tool: A retrospective review

To examine if the electronic N-acetyl cysteine (NAC) order reduced prescribing errors.

This was a retrospective chart review of all patients presenting over 2 years to Cairns Hospital ED with a discharge diagnosis of 'paracetamol overdose'. Data were collected for any patient who received i.v. NAC. Any error, and a description of the error such as dose, volume of fluid, time of infusion and incorrect patient weight was recorded.

There were 172 presentations with paracetamol poisoning with 86 receiving i.v. NAC. In the 75 (87%) where the electronic NAC order was used, there were no errors in dose of NAC, volume of i.v. fluid and length of time of infusion. In the 11 presentations where the manual NAC order was used, there were multiple errors identified.

The use of this electronic NAC order removed errors in NAC prescription and should be considered for prescribing and administering i.v. NAC.