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Award winning, revolutionary paracetamol practice with environmental saving of 700kg CO2 equivalent

Thursday 28th March 2024

Paracetamol is one of the most widely prescribed drugs for hospital inpatients but it has been identified as an area for environmental savings. In the Grange University Hospital alone, a new process could see a saving of £13,000, a 400kg plastic waste reduction and 700kg carbon eq saving per year. 

Ben Prince, Anaesthetics Sustainability Clinical Fellow said: “We’re trying to reduce the use of intravenous (IV) paracetamol where oral can be used. Giving patients oral paracetamol is widely known to increase patient safety and there’s also benefits cost-wise and environmentally.”

Whilst working in the Intensive Care Unit at The Grange University Hospital, Ben Prince and his colleagues noticed that many patients were receiving IV paracetamol doses when oral paracetamol tablets would be just as effective.

On inpatient wards, the IV line packaging and associated empty bottle would be thrown into the clinical waste after each dose of medication. This results in higher plastic waste; when compared to oral paracetamol which simply uses a blister pack to contain multiple doses of medication.

Many studies have demonstrated paracetamol is equally as effective when given orally compared to the intravenous route.

In conjunction with the Aneurin Bevan University Health Board’s Pharmacy team, Ben and the team introduced an intervention on the automated pharmacy dispensing units, the Omnicell.

This intervention was a prompt for nursing staff to consider whether oral paracetamol could be given instead of IV when it was selected on the machine.

This intervention allows nursing staff to maintain autonomy in deciding what is best for their patients. Nurses are more empowered to abide by the 5Rs, right time, right patient, right medication, right dose, right route.

The resulting change was very encouraging, with a 21% reduction in IV paracetamol use and now only 24% of IV paracetamol was given without clear indication. This has since been expanded to patient wards at The Grange University Hospital and Health Board wide.

Earlier this year, Ben was awarded the 2023 Barema & Association of Anaesthetists Environmental award for this initiative.

Ben continued: “We’ve been really happy with the positive results we’ve had, hopes for the future are that we’ll add in more medications and spread it Wales wide.”