Key result
A modified WHO pause and sticker initiative boosts local anaesthetic documentation to ~95%.
Why the study?
Guidance recommends calculating and documenting the maximum safe dose of local anaesthetics and recording drug concentration in mg.ml −1 during widespread peri-operative use.
Do quality improvement interventions improve the documentation of local anaesthetic dosing in adult surgical patients?
Do quality improvement interventions improve the documentation of local anaesthetic dosing in adult surgical patients?
Absolute Event Rate: 95% vs 0%
Low-cost workflow interventions, such as a modified WHO sign-in pause and standardized documentation stickers, can significantly improve the documentation of safe local anaesthetic dosing.
May improve documentation compliance with safety standards; leaves open whether gains reduce LAST events.
Summary The use of local anaesthetics is widespread in peri‐operative care and guidance recommends calculating and documenting the maximum safe dose and recording drug concentration in mg.ml −1 . We conducted a single‐centre quality improvement project to improve documentation of local anaesthetic dosing in 357 adult surgical patients. Six plan‐do‐study‐act cycles were implemented over 10 months, including staff education, a dose‐calculation nomogram, a modified WHO sign‐in pause and a standardised local anaesthetic documentation sticker. At baseline, no record documented the maximum dose or recorded concentration using mg.ml −1 . After introducing the sign‐in pause and documentation sticker, statistical process control charts showed a sustained improvement in documentation, with rates > 95%. These low‐cost workflow interventions may support more standardised documentation and shared team awareness.
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Featherstone et al. (2026) studied Adult surgical patients requiring local anaesthetics (n=357). Quality improvement interventions (staff education, dose-calculation nomogram, modified WHO sign-in pause, standardised documentation sticker) vs. Baseline (pre-intervention) was evaluated on Documentation of the maximum safe dose and drug concentration in mg.ml-1. A quality improvement initiative including a modified WHO sign-in pause and documentation sticker improved local anaesthetic documentation rates from 0% at baseline to >95%.
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