WSYD-PROC200982.docx

**Procedure** **Date Created** 1^st^ August 2008 ----------------------------- ------------------- **Last Updated** 9^th^ July 2019 **Version Number** 4.0 **Drug Committee Approved** 15^th^ July 2019 *Western Sydney Local Health District Page 1 of 2...

**Procedure** **Date Created** 1^st^ August 2008 ----------------------------- ------------------- **Last Updated** 9^th^ July 2019 **Version Number** 4.0 **Drug Committee Approved** 15^th^ July 2019 *Western Sydney Local Health District Page 1 of 22* Purpose ======= Intended Audience ================= Expected Outcomes ================= - PCA pumps are programmed and loaded correctly adhering to the "5 rights of medication administration". - Patients receive optimal analgesia. - Patients are monitored regularly for signs of any adverse effects of analgesic medications administered via PCA. - Any adverse effects to analgesia are appropriately managed. Definitions =========== Procedure ========= PRESCRIPTION - PCA ------------------ - Route, primary drug, amount (in mg or micrograms) - Total volume and drug concentration  Additional drug (if applicable) - Date, prescriber's signature, printed name and contact. - Date and time - Bolus dose stated in both drug unit and volume - Lockout time in minutes - Background / continuous infusion (if applicable), stated in both drug unit and volume - Prescriber's signature, printed name and contact **Safety Alert:** **No other opioids or sedatives to be prescribed for patients whilst on PCA unless** **discussed with the APS. Prescribers MUST add "NOT whilst on PCA" to the order** **comments of any electronically prescribed PRN opioid medications** PRESCRIPTION - NEURAXIAL OPIOID (intrathecal or epidural) --------------------------------------------------------- - Select frequency of observations to be recorded: - Date, time (of administration) - Drug (morphine only, not for fentanyl) - Route (epidural or spinal) - Dose given  PRESCRIPTION -- NALOXONE ------------------------ PRESCRIPTION -- OXYGEN DELIVERY ------------------------------- PCA OPIOID SOLUTIONS -------------------- - Draw up total amount of opioid ordered for PCA on the NSW Health PCA adult chart (SMR130.025) - Add to 0.9% sodium chloride bag the total volume ordered so correct concentration is achieved. - Label the bag as: PROGRAMMING CADD Solis PCA PUMP ------------------------------- - Turn pump on at power button on right hand side of pump  Pump will ask "Do you want to start a new patient?" -- Press "Yes" - Is the hospital correct? -- Press "Yes" - Select Therapy -- PCA -- Press "Select" - Select drug -- Select the opioid solution prescribed on the NSW Health PCA adult chart (SMR130.025) - Enter code using the arrow keys to select each digit -- accept value - Check all parameters are in accordance to the PCA prescription -- Press "Yes" - Review pump settings -- "Accept Value" for each of the parameters in accordance to the PCA prescription -- press "Next" - Prime tubing? --Release clamp on giving set, press "Yes" - Pump will state message -- "Disconnect tubing from patient, open clamps, then press "Prime"  Pump will prompt you to "Turn pump with latch facing down" to prevent air entering giving set - "Stop priming" once line is primed (approximately 3mLs to prime the giving set) - Pump will read "Continue priming" - Press "No" - Connect to appropriate cannula / lumen with compatible Intravenous fluids -- press - Green screen reading "Running" will confirm infusion has commenced ADINISTRATION OF PCA -------------------- - PCA may be administered via an intravenous route (peripheral or central) or subcutaneously. - Administration of PCA opioid must be signed as administered by the registered nurse and checking nurse or doctor on the 'Record of PCA administration and discard page' of the NSW PCA adult chart (SMR130.025) or electronically if electronic medical record in use. Example documentation of administration of PCA below (table - Advise the patient that their PCA has commenced and provide education on how and when to use it. - **ONLY THE PATIENT IS TO USE THE "PATIENT INJECTION BUTTON"** (unless a Nurse Controlled Analgesia option is ordered -- see Nurse Controlled analgesia section) TABLE 2: Administration of PCA opioid documentation example: CHANGING PCA Solution in the PCA pump ------------------------------------- - Open PCA Pump lockbox using the CADD Solis PCA key - Press stop button on front of PCA pump, pump will read "Stop pump?" -- press "Yes" - Spike new PCA solution using appropriate non touch technique  Use arrow on PCA pump to highlight "Reservoir Vol.". Press "Select" - Enter 3 digit code, then press "Accept Value" - Screen will read Reservoir Vol." -- "Press select to reset to 100mL' - By pressing select this will reset the reservoir volume to 100mLs. If for some reason a smaller volume was to be selected utilising the arrows above and below select button can be used - Press "Save" - Press "Start" - Pump screen will read "Review pump settings" -- press "Review" button - "Press "Accept Value" for each of the parameters as prescribed on the NSW Healthy PCA adult chart (SMR130.025) - Press "Next" - Pump will read "Start pump?" -- Press "Yes" - Green screen reading "Running" will confirm infusion has commenced ROUTINE CHECKING OF PCA PUMP PROTOCOLS -------------------------------------- OBSERVATIONS ------------ - A pain assessment score, R = rest, M = movement - Sedation score - Respiratory rate - Oxygen therapy - Presence of nausea or vomiting - Total PCA dose -- this is obtained by pressing "Reports" button on front of PCA pump, then selecting "Given and PCA dose counters" - Background infusion rate (if applicable) - PCA program check FREQUENCY OF OBSERVATIONS ------------------------- - Administer other prescribed non-opioid analgesics. - Check PCA pump is functioning correctly and IV access is patent. - Contact the APS or nominated equivalent medical officer for patient to be reviewed. - **Pruritus or persistent nausea or vomiting:** Administer PRN medication as prescribed in the patient's eMEDS. If adverse effect continues, contact APS or equivalent medical officer. - **Urinary retention:** contact patient's surgical or medical team. - **Constipation:** Prophylactic aperient therapy can be beneficial. Contact the patient's surgical / medical team.  Management of INCREASING SEDATION and RESPIRATORY DEPRESSION -------------------------------------------------------------- - Have pain scores previously been in the White Zone (0 to 6)? - Does the patient understand how to use the PCA? - Have additional prescribed analgesics been administered? - Has the patient been reviewed by the Acute Pain Service or equivalent Medical Officer? - The assessing nurse may need to consult with the NURSE IN CHARGE to decide whether a CLINICAL REVIEW (or other CERS- Clinical Emergency Response) call should be made  TABLE 4: Sedation and respiratory rate monitoring colour coding TABLE 5: Instructions for Clinical review or Rapid Response:  OBSTRUCTIVE SLEEP APNOEA ------------------------ NURSE CONTROLLED ANALGESIA -------------------------- **Safety Alert:** **When NCA is being administered to patients it may appear that the patient is confused** **and / or agitated due to insufficient analgesia. Nursing staff must be mindful of** **other causes for confusion. Careful observation of sedation and respiratory function is required** **and a medical officer should review the patient if there is uncertainty regarding the cause** **of confusion.** Blood Transfusions ------------------ Administration of Medications via Intravenous Line attached to PCA ------------------------------------------------------------------ Patients with PCA leaving the ward/hospital environment ------------------------------------------------------- Ceasing PCA ----------- TABLE 6: PCA opioid discard documentation example: **Risk category**: *Clinical Care & Patient Safety* **Risk rating:** *Medium* +-----------------------------------+-----------------------------------+ | document -- more than 1 standard | | | can apply*.* | | +===================================+===================================+ | ☐ **Standard 1** -- Clinical | ☒ **Standard 2** -- Partnering | | Governance | with Consumers | +-----------------------------------+-----------------------------------+ | ☐ **Standard 3** - Preventing and | ☒ **Standard** 4 -- Medication | | Controlling | Safety | | | | | Healthcare Associated Infection | | +-----------------------------------+-----------------------------------+ | ☐ **Standard 5** -- Comprehensive | ☐ **Standard 6** -- Communicating | | Care | for Safety | +-----------------------------------+-----------------------------------+ | ☐ **Standard 7** -- Blood | ☒ **Standard 8** - Recognising | | Management | and | | | | | | Responding to Acute Deterioration | +-----------------------------------+-----------------------------------+ Implementation Plan =================== **Implementation Timeframe** ------------------------------------------------------------------------------------------------------ -- **Author** **Department Manager** **Position Responsible** **Brief description of the implementation strategy (link to all resources available or developed):** Education Notes =============== Definition of PCA ----------------- Advantages of PCA -----------------  Patient Age -------------  Communication difficulties ----------------------------  Psychological characteristics -------------------------------  **Concurrent disorders:** Inappropriate use of PCA ------------------------ Equipment Factors / Anti reflux - syphon valve ---------------------------------------------- Opioid tolerant patient groups in the acute setting --------------------------------------------------- - Patients with chronic pain, cancer or non-cancer pain being treated with opioids. - Patients with a substance abuse disorder either using illicit opioids or on an opioid maintenance program. - Patients who have developed acute opioid tolerance due to peri operative opioid administration. - Patients with a suspected opioid tolerance where their history is not available or accurate.  Loading dose --------------  Bolus dose ------------  Lockout interval ------------------  Background infusion/continuous infusion -----------------------------------------  Opioid drugs used -------------------  PCA Programming ----------------- OPIOID INDUCED VENTILATORY IMPAIREMENT (OIVI) --------------------------------------------- - Central depression of the respiratory centre which can lead to a decreased respiratory rate and/or tidal volume - Depression of the central nervous system in general, leading to reduced consciousness (sedation); and - Depression of supraglottic airway muscle tone, leading to upper airway obstruction -- if obstruction is not complete the patient may snore ^7^ References ========== 1. Macintyre P.E. Safety and efficacy of patient-controlled analgesia. British journal of anaesthesia. 2001 87;(1): 36-46 2. Australian and New Zealand College of anaesthetists and faculty of pain medicine. Acute Pain Management Scientific Evidence. 4th ed. 2015. National Health and Medical Research Council. 3. [[NSW Health. Medication handling in NSW Public Health Facilities. PD2013\_043]](https://www1.health.nsw.gov.au/pds/ActivePDSDocuments/PD2013_043.pdf) 4. Macintyre P E, Schug S A. Acute pain management a practical guide.4th ed. Edinburgh: Saunders Elsevier; 2010 5. [[WSLHD Implememtation Plan -- User Applied Labelling of Injectable Medicines, Fluids] [and Lines. PD2016\_058]](https://policydatabase.wslhd.health.nsw.gov.au/wslhd_docv3/Reports/ActivePDF.aspx?action=open&docid=WSYD-IP202826&release=1) 6. [[WSLHD. Medication Administration Compliance Procedure for Nurses and Midwives] [within WSLHD Acute Health Care Facilities. 2015. WSYD-PCP202108]](https://policydatabase.wslhd.health.nsw.gov.au/wslhd_docv3/Reports/ActivePDF.aspx?action=open&docid=WSYD-PCP202108&release=1) 7. Macintyre P E, Schug S A. Acute pain management a practical guide.4th ed. Edinburgh: Saunders Elsevier; 2015 8. [[Clinical Excellence Commission. Between the Flags program]](http://www.cec.health.nsw.gov.au/patient-safety-programs/adult-patient-safety/between-the-flags) 9. Clinical Excellence Commission. 2013. Patient safety watch. Edition 1/13: Sleep apnoea. 10. [[WSLHD. Use of established CPAP therapy in OSA Inpatients (Westmead). 2012,]](https://policydatabase.wslhd.health.nsw.gov.au/wslhd_docv3/Reports/ActivePDF.aspx?action=open&docid=WSYD-POLY201773&release=1) 11. Government of South Australia Department of Health. Flippin' blood. 2nd ed. 2012. Flippin\' Blood: A BloodSafe flip chart to help make transfusion straightforward :: Transfusion resources 12. [[WSLHD.Administration of Blood Products.2017.WSYD-PCP201834]](https://policydatabase.wslhd.health.nsw.gov.au/wslhd_docv3/Reports/ActivePDF.aspx?action=open&docid=WSYD-PC201834&release=1) 13. [[WSLHD. Clinical Handover. 2014. WSYD-PCP201820]](https://policydatabase.wslhd.health.nsw.gov.au/wslhd_docv3/Reports/ActivePDF.aspx?action=open&docid=WSYD-PC201820&release=1) 14. Carr ECJ, Thomas VN, Wilson-Baret J. Patient experiences of anxiety, depression and acute pain after surgery: a longitudinal perspective. International Journal of Nursing. 2005 July; 42(5): 521-530. 15. Rutherford J, Patri M. Failure of antireflux valve in a Vygon PCA set. Anaesthesia. 2004; 59: 511. 16. Mitra S, Sinatra R. Perioperative management of Acute pain in the opioid dependent patient. Anaesthesiology. 2004; 101:212-27. 17. ECRI. Abbott PCA plus II patient controlled analgesia pumps prone to mis-programming resulting in narcotic over infusions. Health devices.1997; 26: 389-91 18. ERCI. Medication safety: PCA pump programming errors continue to cause fatal infusion. Heath devices. 2002; 31: 342-46. 19. [[WSYD Procedure Document: Management of supplemental oxygen therapy in adult] [patients procedure WSYD-PROC200947]](https://policydatabase.wslhd.health.nsw.gov.au/wslhd_docv3/Reports/ActivePDF.aspx?action=open&docid=WSYD-PROC200947&release=1) 20. [[WSLHD Procedure Document: Management of adult patients receiving PCA (Patient] [Controlled Analgesia) at Mt Druitt Hospital. WSYD-PROC201124]](https://policydatabase.wslhd.health.nsw.gov.au/wslhd_docv3/Reports/ActivePDF.aspx?action=open&docid=WSYD-PROC201124&release=1) Version History =============== **Date** ------------ -- -- -- 30/04/2010 16/02/2012 14/02/2013 +-----------------+-----------------+-----------------+-----------------+ | | | departments. | | | | | p.11 | | | | | | | | | | PCA may be used | | | | | when patients | | | | | are being | | | | | temporarily | | | | | transferred to | | | | | another | | | | | hospital for | | | | | tests as the | | | | | PCA pumps are | | | | | the same at all | | | | | WSLHD | | | | | facilities. | | | | | p.11 | | | | | | | | | | Subdirectory | | | | | Auburn: PCA | | | | | device and | | | | | given set used | | | | | corrected. | | | | | Westmead: | | | | | HYDROmorphone | | | | | added p.22 | | +=================+=================+=================+=================+ | 07/03/2013 | 2.3 | Scanned | E.Edmonds / | | | | examples of PCA | S.Pagett | | | | chart updated | | | | | with final | | | | | version of the | | | | | NSW PCA chart - | | | | | adult | | | | | \[SMR130.025\]. | | | | | p.17-18 | | +-----------------+-----------------+-----------------+-----------------+ | 14/03/2013 | 2.4 | Opioids or | H.Currow / | | | | sedatives may | | | | | be prescribed | E.Edmonds | | | | only when | | | | | authorised by | S.Pagett / | | | | the Acute Pain | | | | | Service p.4 | E.Edmonds | | | | | | | | | Giving set with | H.Currow / | | | | anti-reflux and | | | | | anti-siphon | E.Edmonds | | | | must be used. | | | | | p.7 | | | | | | | | | | PCA pump | | | | | storage | | | | | location see | | | | | subdirectory | | | | | p.12, 22-24 | | +-----------------+-----------------+-----------------+-----------------+ | 21/03/2013 | 2.5 | Grammatical | S.Pagett / | | | | amendments as | E.Edmonds | | | | per Louise Cope | | | | | | | | | | from Nursing | | | | | and Midwifery | | | | | Procedure | | | | | Committee | | | | | Westmead | | | | | Hospital | | +-----------------+-----------------+-----------------+-----------------+ | 25/03/2013 | 2.6 | Opioids or | H.Currow / | | | | sedatives may | | | | | be prescribed | E.Edmonds | | | | only when | | | | | authorised by | S.Pagett / | | | | the Acute Pain | | | | | Service p.4 | E.Edmonds | | | | Giving set with | | | | | anti-reflux and | H.Currow / | | | | anti-siphon | | | | | must be used. | E.Edmonds | | | | p.7 | | | | | | | | | | PCA pump | | | | | storage | | | | | location see | | | | | subdirectory | | | | | p.12, 22-24 | | | | | | | | | | The term "who | | | | | are trained" | | | | | following | | | | | | | | | | Anaesthetists | | | | | removed from | | | | | Blacktown and | | | | | Mt | | | | | | | | | | Druitt | | | | | subdirectory as | | | | | requested by Dr | | | | | Halliwell | | +-----------------+-----------------+-----------------+-----------------+ | 2/4/2015 | 2.7 | Removed | E.Edmonds | | | | reference to | | | | | PCEA and | | | | | epidural | | | | | | | | | | procedure (PCEA | | | | | not used at | | | | | Westmead or | | | | | BMDH) | | | | | | | | | | Information | | | | | relating to | | | | | drug | | | | | concentrations | | | | | and standard | | | | | solutions moved | | | | | into Equipment | | | | | section. | | | | | Statement | | | | | referring to | | | | | subdirectory | | | | | removed -- | | | | | replaced with | | | | | 'for less | | | | | commonly used | | | | | solutions that | | | | | may be used at | | | | | Westmead or | | | | | | | | | | Blacktown refer | | | | | to Acute Pain | | | | | Service at | | | | | Westmead or | | | | | Blacktown p. 4 | | | | | | | | | | Prescription | | | | | section | | | | | formatted to | | | | | reflect | | | | | prescription | | | | | page of NSW PCA | | | | | chart with | | | | | relevant | | | | | headings for | | | | | each item | | | | | including | | | | | prescription | | | | | and PCA | | | | | program. p.5 | | | | | | | | | | PCA | | | | | prescription | | | | | validity 4 days | | | | | unless ceased | | | | | earlier. | | | | | | | | | | Examples for | | | | | fentanyl and | | | | | morphine PCA | | | | | prescription | | | | | and program | | | | | combined and | | | | | updated | | +-----------------+-----------------+-----------------+-----------------+ +-----------------+-----------------+-----------------+-----------------+ | | | as per changes | | | | | to NSW PCA | | | | | chart. p.5 | | | | | Example for | | | | | Neuraxial | | | | | opioid | | | | | prescription | | | | | updated | | | | | | | | | | Prescription | | | | | for naloxone: | | | | | added statement | | | | | 'naloxone for | | | | | the treatment | | | | | of pruritus to | | | | | be prescribed | | | | | on PRN section | | | | | of medication | | | | | chart. p.7 | | | | | | | | | | Example for | | | | | naloxone | | | | | prescription | | | | | updated | | | | | | | | | | Added | | | | | prescription | | | | | for oxygen | | | | | delivery. | | | | | Existing | | | | | statement | | | | | relating to | | | | | oxygen delivery | | | | | moved into | | | | | prescription | | | | | section and | | | | | updated to | | | | | reflect changes | | | | | to the NSW PCA | | | | | chart. | | | | | | | | | | PCA. p.7 | | | | | | | | | | Additional | | | | | instructions | | | | | and formatting | | | | | of | | | | | | | | | | programming the | | | | | alaris PCAM | | | | | pump section. | | | | | p.89 | | | | | | | | | | Added | | | | | instruction for | | | | | how to change a | | | | | PCA syringe. | | | | | p.10 | | | | | | | | | | Added section | | | | | 'Routine | | | | | checking of PCA | | | | | pump protocols | | | | | PCA program | | | | | prescription. | | | | | p.10 | | | | | | | | | | Observations: | | | | | pain assessment | | | | | score -- added | | | | | | | | | | R=rest, | | | | | M=movement. | | | | | p.11 | | | | | | | | | | Management of | | | | | increasing | | | | | sedation and | | | | | respiratory | | | | | depression -- | | | | | updated | | | | | instructions | | | | | for clinical | | | | | review or rapid | | | | | response as per | | | | | changes to NSW | | | | | PCA chart. p.12 | | +=================+=================+=================+=================+ | 04/05/15 | 2.7 | Changing of PCA | S.Pagett | | | | syringes only | | | | | when syringe is | | | | | nearly empty. | | | | | Routine | | | | | changing of | | | | | syringes is not | | | | | required | | +-----------------+-----------------+-----------------+-----------------+ | 25/05/15 | 2.7 | Grammatical | Z. Mahachi | | | | improvements | (Clinical | | | | throughout | | | | | document | Governance) | | | | p.3,4,7 | | | | | | E.Edmonds | | | | 'APS or | | | | | equivalent | | | | | medical | | | | | officer' added | | | | | to definitions | | | | | | | | | | Term | | | | | 'reconstitution | | | | | ' | | | | | added to | | | | | section | | | | | regarding | | | | | drawing up of | | | | | non-preloaded | | | | | syringes p.7 | | | | | Additional | | | | | information | | | | | added regarding | | | | | opioid induced | | | | | ventilatory | | | | | impairment | | | | | added to p.11 | | | | | | | | | | Opioid induced | | | | | ventilatory | | | | | impairment | | | | | added to | | | | | education notes | | | | | p.17 | | +-----------------+-----------------+-----------------+-----------------+ | 7/6/2018 | 2.8 | Addition of 2 | S.Pagett | | | | comments under | | | | | the Nurse | | | | | Controlled | | | | | Analgesia | | | | | section: | | | | | | | | | | -NCA must only | | | | | be prescribed | | | | | and managed in | | +-----------------+-----------------+-----------------+-----------------+ | | | the Intensive | | | | | Care or High | | | | | Dependency / | | | | | Close | | | | | Observation | | | | | units | | | | | | | | | | -When NCA is | | | | | being | | | | | administered to | | | | | patients who | | | | | are confused, | | | | | care must be | | | | | taken to ensure | | | | | all potential | | | | | causes for | | | | | confusion are | | | | | investigated | | | | | and the nurse | | | | | should not | | | | | presume | | | | | confusion and / | | | | | or agitation | | | | | are solely pain | | | | | related. | | | | | Careful | | | | | observation of | | | | | sedation and | | | | | respiratory | | | | | function is | | | | | required. | | +-----------------+-----------------+-----------------+-----------------+ | 30/7/2018 | 2.9 | Safety alert | S. Pagett | | | | box placed in | | | | | the Nurse | | | | | Controlled | | | | | analgesia | | | | | section, with | | | | | some changing | | | | | to the wording | | | | | regarding | | | | | patient | | | | | monitoring as | | | | | recommended by | | | | | the ADC | | +-----------------+-----------------+-----------------+-----------------+ | 22/1/2019 | 3 | Addition of | S. Pagett | | | | comment | | | | | regarding | | | | | ensuring | | | | | compatibility | | | | | of medications | | | | | if being | | | | | administered | | | | | via the | | | | | maintenance | | | | | line attached | | | | | to the PCA | | +-----------------+-----------------+-----------------+-----------------+ | 24/4/2019 | 3.2 | Removal of the | S.Pagett | | | | word syringe | | | | | and replaced | | | | | with bag to | | | | | accommodate | | | | | change to new | | | | | PCA pumps | | | | | across LHD | | | | | | | | | | Changes of PCA | | | | | pump details in | | | | | preparation for | | | | | changeover to | | | | | CADD Solis PCA | | | | | pumps | | +-----------------+-----------------+-----------------+-----------------+ | 26/5/2019 | 3.3 | Addition of | S. Pagett | | | | information on | | | | | compatibility | | | | | of | | | | | HYDROmorphone | | | | | and blood | | | | | products in | | | | | accordance with | | | | | latest WSLHD | | | | | Administration | | | | | of Blood | | | | | products | | | | | Procedure | | +-----------------+-----------------+-----------------+-----------------+ | 29/5/2019 | 3.4 | Correction of | S. Pagett | | | | some typos, | | | | | Addition of | | | | | information re | | | | | Pain Assessment | | | | | (Table 3), | | | | | addition of | | | | | comment re: RNs | | | | | ceasing PCAs as | | | | | recommended by | | | | | Emily Edmonds | | +-----------------+-----------------+-----------------+-----------------+ | 22/6/2019 | 3.5 | Changes made as | S.Pagett | | | | recommended by | | | | | the WSLHD P,P&G | | | | | Committee | | +-----------------+-----------------+-----------------+-----------------+ | 9/7/2019 | 3.6 | Addition of | S.Pagett | | | | hyperlink to | | | | | the Mt Druitt | | | | | procedure | | | | | regarding | | | | | cessation of | | | | | PCA on page 3 | | | | | and addition of | | | | | safety alert on | | | | | page 6 as | | | | | recommended by | | | | | Marcelle appay | | | | | on behalf of | | | | | the ADC | | +-----------------+-----------------+-----------------+-----------------+ | 15 July | 4.0 | Approved by the | S.Pagett | | | | WSLHD Drug | | | 2019 | | Committee | | +-----------------+-----------------+-----------------+-----------------+  **PCA (Patient Controlled Analgesia) for Adult Patients \> 16years - WSLHD \[Release 1\]** +-----------------------------------+-----------------------------------+ | DocumentID | WSYD-PROC200982 | +===================================+===================================+ | Title | PCA (Patient Controlled | | | Analgesia) for Adult Patients \> | | | 16years - WSLHD | +-----------------------------------+-----------------------------------+ | Alternative Title | | +-----------------------------------+-----------------------------------+ | Creator Corporate Name | Western Sydney Local Health | | | District | +-----------------------------------+-----------------------------------+ | Author | Suzanne Pagett | +-----------------------------------+-----------------------------------+ | Author Position | Clinical Nurse Consultant | +-----------------------------------+-----------------------------------+ | Author Email | Suzanne.Pagett\@health.nsw.gov.au | +-----------------------------------+-----------------------------------+ | Contributor | Emily Edmonds; Karen Blunden | +-----------------------------------+-----------------------------------+ | Endorsement | Drug Committee | +-----------------------------------+-----------------------------------+ | Publisher | Western Sydney Local Health | | | District | +-----------------------------------+-----------------------------------+ | Subject | PCA (Patient Controlled | | | Analgesia) for Adult Patients \> | | | 16years - WSLHD | +-----------------------------------+-----------------------------------+ | Keywords | Pain, Analgesia, Patient | | | Controlled | +-----------------------------------+-----------------------------------+ | Description | This procedure will detail the | | | management of patients receiving | | | PCA. | | | | | | PCA is a modality of | | | administering intravenous or | | | subcutaneous medication for pain | | | management. A PCA device will | | | administer a programmed dose of | | | the medication when a handheld | | | button is pressed. | +-----------------------------------+-----------------------------------+ | Version | 4.0 | +-----------------------------------+-----------------------------------+ | Classification | Procedure | +-----------------------------------+-----------------------------------+ | Source | Medication Handling in NSW Public | | | Health Facilities | | | | | | Medication Administration | | | Compliance Procedure for Nurses | | | and Midwives within WSLHD Acute | | | Health Care facilities | | | | | | High risk medications Policy | | | | | | ANZCA Scientific Guidelines | +-----------------------------------+-----------------------------------+ | Date Created | 01 Aug 2008 | +-----------------------------------+-----------------------------------+ | Date Modified | 17 Jul 2019 | +-----------------------------------+-----------------------------------+ | Date Valid From | 17 Jul 2019 | +-----------------------------------+-----------------------------------+ | Date Valid To | 17 Jul 2023 | +-----------------------------------+-----------------------------------+ | Date Issued | 17 Jul 2019 | +-----------------------------------+-----------------------------------+ | TRIM File Number | \- | +-----------------------------------+-----------------------------------+ | TRIM Record Number | WSPP18/18 | +-----------------------------------+-----------------------------------+ | Language | English | +-----------------------------------+-----------------------------------+ | Relation | N/A | +-----------------------------------+-----------------------------------+ | Security | Unclassified | +-----------------------------------+-----------------------------------+ | Risk Rating | Medium | +-----------------------------------+-----------------------------------+ | Key Contact | Yen Yi Alderton, Drug Committee | | | Pharmacist, 02 8890 3604, | | | WSLHD-DrugCommittee\@health.nsw.g | | | ov.au | +-----------------------------------+-----------------------------------+ | Availability | On Line | +-----------------------------------+-----------------------------------+ | LHD / Hospital | WSLHD | +-----------------------------------+-----------------------------------+ | Functional Group | Western Sydney LHD | +-----------------------------------+-----------------------------------+ | Identifer | WSLHD Publication Number: - | +-----------------------------------+-----------------------------------+ | Audience | Overall | +-----------------------------------+-----------------------------------+ | National Standard | Standard 4 -- Medication Safety | +-----------------------------------+-----------------------------------+