Skip to main content

Main menu

  • Home
  • Our journals
    • Clinical Medicine
    • Future Healthcare Journal
  • Subject collections
  • About the RCP
  • Contact us

Future Healthcare Journal

  • FHJ Home
  • Content
    • Current
    • Ahead of print
    • Archive
  • Author guidance
    • Instructions for authors
    • Submit online
  • About FHJ
    • Scope
    • Editorial board
    • Policies
    • Information for reviewers
    • Advertising

User menu

  • Log in

Search

  • Advanced search
RCP Journals
Home
  • Log in
  • Home
  • Our journals
    • Clinical Medicine
    • Future Healthcare Journal
  • Subject collections
  • About the RCP
  • Contact us
Advanced

Future Healthcare Journal

futurehosp Logo
  • FHJ Home
  • Content
    • Current
    • Ahead of print
    • Archive
  • Author guidance
    • Instructions for authors
    • Submit online
  • About FHJ
    • Scope
    • Editorial board
    • Policies
    • Information for reviewers
    • Advertising

Patience, persistence and Pabrinex – a junior doctor’s experience of overcoming obstacles to change hospital policy

Chenai Mautsi
Download PDF
DOI: https://doi.org/10.7861/futurehosp.3-2-s4
Future Healthcare Journal June 2016
Chenai Mautsi
1NHS Education for Scotland, Edinburgh, Scotland, UK
2NHS Lothian, Edinburgh, Scotland, UK
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Info & Metrics
Loading

Aims

To develop and establish an evidence-based policy for the treatment and prevention of Wernicke's encephalopathy in patients undergoing alcohol detoxification in an alcohol and substance misuse unit.

Methods

  1. The administrative route of thiamine replacement (Pabrinex) was audited for patients admitted during April 2015 (n = 20).

  2. A literature review was undertaken to determine the gold standard of care.

  3. Guidelines were developed using the up-to-date recommendations.

  4. Consultations with the multidisciplinary team identified practical implications and concerns of providing such care.

Results

Only 15% of the patients were treated in concordance with the gold standard treatment (intravenous Pabrinex). 85% received the second-line intervention, intramuscular thiamine, with subsequent subtherapeutic dosage. The obstacles to introducing intravenous administration included historical practice, lack of intravenous drug training for mental health nurses, misconceptions of peripheral venous cannulation-associated infection and equipment deficits. Additionally, the risk factors and symptomatology of Wernicke's encephalopathy were poorly understood.

Conclusions

The main barrier to change was challenging nursing staff perceptions of best practice as a junior member of medical staff, following over a decade of undisputed intramuscular administration. Open channels of communication with nursing colleagues and the support of medical consultants were of utmost importance to ensure successful implementation of the new guideline. Following interdisciplinary teaching and determined championing of the policy change, the updated guidelines are now in place. Mental health nurses received training to administer intravenous medications and funds for intravenous pumps were granted. The unit is a hospital leader for clinical innovation and ultimately patient care has been optimised. Junior doctors are in an ideal position to lead improvements in service provision but time, patience and persistence are required.

  • © Royal College of Physicians 2016. All rights reserved.
Back to top
Previous articleNext article

Article Tools

Download PDF
Article Alerts
Sign In to Email Alerts with your Email Address
Citation Tools
Patience, persistence and Pabrinex – a junior doctor’s experience of overcoming obstacles to change hospital policy
Chenai Mautsi
Future Healthcare Journal Jun 2016, 3 (Suppl 2) s4; DOI: 10.7861/futurehosp.3-2-s4

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Share
Patience, persistence and Pabrinex – a junior doctor’s experience of overcoming obstacles to change hospital policy
Chenai Mautsi
Future Healthcare Journal Jun 2016, 3 (Suppl 2) s4; DOI: 10.7861/futurehosp.3-2-s4
del.icio.us logo Digg logo Reddit logo Twitter logo CiteULike logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
    • Aims
    • Methods
    • Results
    • Conclusions
  • Info & Metrics

Related Articles

  • No related articles found.
  • Google Scholar

Cited By...

  • No citing articles found.
  • Google Scholar

More in this TOC Section

  • Obtaining an ‘informed’ consent for primary percutaneous coronary intervention (PPCI) in non-English speaking patients…the dilemma
  • Learning from mistakes: a review of clinical incidents occurring at Royal Surrey County Hospital and how we can learn from these to improve patient outcomes
  • Characteristics of patients with chronic obstructive pulmonary disease (COPD) admitted to a tertiary referral hospital
Show more HEALTH SERVICE AND POLICY

Similar Articles

Navigate this Journal

  • Journal Home
  • Current Issue
  • Ahead of Print
  • Archive

Related Links

  • ClinMed - Home
  • FHJ - Home

Other Services

  • Advertising
futurehosp Footer Logo
  • Home
  • Journals
  • Contact us
  • Advertise
HighWire Press, Inc.

Follow Us:

  • Follow HighWire Origins on Twitter
  • Visit HighWire Origins on Facebook

Copyright © 2021 by the Royal College of Physicians