Opioid Prescribing Safety Audit

This project audits whether opioid prescribing is clinically justified, proportionate, reviewed and safely documented. It reviews indication and pain assessment, opioid status, prescription detail and PRN limits, review, stop or taper plans, risk factors including renal, frailty, respiratory and sedative co-prescribing, bowel care and monitoring, controlled-drug requirements, counselling and dependence discussion, discharge quantity and duration, medicines reconciliation and transfer-of-care communication.

• Doctors, nurses, pharmacists, pharmacy technicians, ACPs and PAs prescribing or reviewing opioids
• Acute pain, perioperative, surgical, acute medicine and emergency teams
• Primary care, community, care-home and hospice clinical teams where locally included
• QI leads, medicines optimisation, governance and patient safety teams
• Supervisors and educators supporting ARCP and appraisal evidence

• Measure whether opioid indication, assessment and opioid status are documented
• Assess prescription clarity, PRN limits, review dates and stop or taper plans
• Review risk factors, sedative co-prescribing, bowel care and monitoring
• Test discharge quantity, counselling, reconciliation and GP communication
• Generate governance-ready and ARCP-ready evidence and a re-audit cycle

• Anonymous case identifier
• Inclusion / eligibility decision
• Anonymised context (age band, sex/gender recorded, care setting, prescribing context)
• Clinical area / location and optional specialty / service
• Twenty-one opioid prescribing safety criteria (met / not met / not applicable)
• Free-text learning points and any project custom fields

• Live dashboard
• Audit report (Word)
• Executive summary (Word)
• Excel workbook
• PowerPoint presentation
• Conference poster
• ARCP evidence summary

• Designed to use anonymised or pseudonymised audit identifiers.
• This tool supports, but does not replace, clinical judgement.
• Local policy, formulary and specialist advice should be followed.
• Organisations remain responsible for local governance arrangements.
• This tool supports documentation and prescribing-safety review only. It does not provide patient-specific prescribing, opioid conversion, tapering, withdrawal management or pain-management advice.
• Doses, oral morphine equivalent thresholds, conversion ratios, tapering schedules, duration limits and monitoring frequencies are locally configured and are not presented here as national standards.
• Use anonymous case identifiers only — never patient-identifiable information.

Supporting guidance from the Lazomis QI Resource Library. Authoritative clinical standards referenced by this project remain separate.

• Clinical GovernanceIntegrating Quality Improvement into Clinical Governance FrameworksThis article explores the vital relationship between Quality Improvement (QI) and Clinical Governance within the NHS, demonstrating how they are two sides of the same coin when aiming for continuous, systematic improvement in patient care.
• Clinical GovernanceEffective Clinical Governance Meetings: Driving Improvement, Not Just ReportingThis guide helps NHS teams redefine their clinical governance meetings, moving beyond mere reporting to foster proactive discussion, shared learning, and tangible improvement actions for patient safety and quality of care.
• Patient SafetyMedicines Safety: A Systems Approach to Reducing HarmThis guide moves beyond individual error, explaining how a systems-based approach can fundamentally improve medicines safety across the NHS and reduce patient harm by addressing underlying contributing factors.
• Quality ImprovementHow Many PDSA Cycles Does a Quality Improvement Project Need?This guide explains the iterative nature of PDSA cycles and offers practical advice for determining the appropriate number of cycles needed for effective quality improvement in NHS settings.