P-66186255-114 - Peri-operative prescribing audit for cleft lip and palate inpatients at Royal Hospital for Children, Glasgow

Abstract

<h3>Background</h3> Cleft lip and palate (CLP) surgery has been reported to result in significant postoperative pain, which can slow post-surgery feeding. Furthermore, postoperative wound infection is a recognized complication that may result in breakdown of the repair. The agreed peri-operative prescribing protocol designated by the National Cleft Surgical Service for Scotland, based at Royal Hospital for Children (RHC) Glasgow, includes peri-operative prescription of regular analgesia, antibiotic prophylaxis and IV fluids, titrated as per oral intake. <h3>Aim(s)/Objective(s)</h3> Review compliance of drug administration with RHC prescribing protocol. <h3>Methods</h3> Patient dataset obtained from logbook of theatre admission attendances to RHC for CLP surgical interventions in 2021. A sample of 30 patient electronic records that met the inclusion criteria were reviewed for prescription of regular analgesia (paracetamol and ibuprofen), antibiotic prophylaxis in line with the protocol and IV fluids as per oral intake. Standards set for 100% of patients to be prescribed analgesia, antibiotics and IV fluids as per the protocol. <h3>Results</h3> In the first cycle, all appropriate patients were prescribed oral antibiotics, 87% received post-operative IV antibiotics, 80% were prescribed regular paracetamol, 57% regular ibuprofen, and 83% received post-operative IV fluids. Posters describing the protocols were displayed in our operating theatres and surgical ward, and discussion of the protocol was introduced into the morning theatre brief. In the second cycle, 100% of patients received their oral and IV antibiotics and paracetamol, 93% received regular ibuprofen and 97% were prescribed post-operative IV fluids. <h3>Conclusions</h3> Improvements evident in compliance with prescribing protocol with education to the theatre and ward staff.