Clinical audit is an essential quality improvement tool in anesthesia and Obstetric Anesthesia practice, ensuring patient safety through adherence to evidence-based standards. Infusion pumps are widely used during Obstetric cases for post delivery Oxytocin Infusions [1].

The aim was to evaluate compliance with recommended standards for Oxytocin infusion and use of standard pump for monitored delivery of drug, including correct dosage calculations, utilization of smart pump drug libraries, and completeness of documentation.

Methods

A prospective audit was conducted over a six-month period at a regional hospital with maternity care. Fifty cases of Caesarean Section were recorded where Oxytocin Infusion and incidence of standard infusion pump usage were reviewed using a standardized audit proforma. Data collected included incidence of use of Infusion pump vs delivery by drip set, infusion rate calculations in both, time of procedures, total volume delivered and documentation practices. Audit standards were based on manufacturer guidelines and institutional policies.

Results

Standardised delivery of Oxytocin by infusion pumps at set rate was observed in 12% of cases, while 88% of infusions were administered without the appropriate pump through intravenous drip sets. Delivered oxytocin infusion rates were accurate in cases where standard pumps were used ; compared to use of IV drip sets which lead to higher oxytocin delivered in all 100% of cases where pumps where not used. Complete documentation was identified in 100% of cases. All infusion pumps met technical performance standards, and no adverse events were reported during the audit period.

Discussion

This audit demonstrated satisfactory overall compliance with infusion pump safety standards were used; however, rate of compliance to standard pump usage  for Oxytocin Infusion was only 12%. Targeted staff education, reinforcement of local guidelines for dosing of oxytocin infusionto avoid overdosage and adverse effects is recommended.