THE USE OF AUDIT TO IMPROVE CLINICAL EFFECTIVENESS IN AN INFREQUENT OBSTETRIC THERAPY - MAGNESIUM-SULFATE IN SEVERE PREECLAMPSIA

Magnesium sulphate has been established as the drug of choice in the m anagement of eclampsia and even when used in cases of severe pre-eclam psia it is given infrequently. It is recognised to have potentially se vere toxic effects but there is a need to achieve therapeutic levels q uickly, enough to prevent seizures. This paper reports at? audit follo wing the introduction of a protocol for the use of magnesium sulphate in eclampsia and severe pre-eclampsia at Ninewells hospital, Dundee. P roblems were identified with both the time taken to reach therapeutic levels and clinical monitoring of magnesium levels despite the use of loading doses commonly recommended. Reaudit after changes to the proto col and the introduction of an administration/monitoring chart showed a significant improvement in both monitoring and the adequacy of proph ylaxis. This demonstrates how audit of clinical practice has been used to improve clinical effectiveness in an area in which a potentially t oxic drug is used infrequently but with potentially life saving benefi ts.