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Safe Administration of Oxytocin

As part of the Safer Birth initiative, the Provincial Council for Maternal and Child Health (PCMCH) has developed best practice recommendations for the safe administration of oxytocin used in augmentation and/or induction. As oxytocin is a high alert medication, there is heightened risk of causing significant patient harm when used in error. The overall goal of this work will be to reduce adverse outcomes associated with the misuse of oxytocin by reducing variation in care and reinforce safe drug administration principles.  To support implementation of these best practices, various tools have been created such as a standardized order set and safety checklist.

About this Project

This work focuses on identifying best practice recommendations that can be applied to low risk pregnant patients who are eligible for oxytocin as a form of augmentation or induction. This report will not address the use of oxytocin for the use of contraction stress test or oxytocin challenge test; risks and benefits associated with other medications or methods of cervical ripening and induction of labour (prostaglandin, dinoprostone, mechanical cervical ripening); administration of oxytocin for postpartum hemorrhage prophylaxis; and oxytocin regimen for intrauterine fetal demise.

The following groups will benefit from this work:

  • Pregnant people and their families: Gain access to reliable information on oxytocin through shared decision making, and receive quality care when being administered this high alert medication.
  • Health care providers: Provide evidence-based information about the appropriate use of oxytocin and support standardized practices associated with its use.
  • Institutions and the Health System: Support standardize hospital operations and reduce adverse outcomes associated with oxytocin use.

This work has been reviewed and informed by the PCMCH Maternal-Neonatal Clinical Advisory Group, Maternal-Neonatal Committee, as well as various external stakeholders (such as the Institute for Safe Medication Practices of Canada, Healthcare Insurance Reciprocal of Canada, and Canadian Medical Protective Association).

This work has been formally endorsed by the following organizations:

Safe Administration of Oxytocin Report – Download PDF

 

 

Tools

Please read and review the report prior to implementing any of the tools listed below.

  1. Standardized Oxytocin Order Set
  2. Standardized Oxytocin Labels
  3. Disagreeing with the plan of care algorithm
  4. Deciding about medication administration algorithm
  5. Pre-Use Safety Checklist 
  6. In-Use Safety Checklist
  7. Pamphlet on IV Oxytocin for Induction and Augmentation of Labour- English
  8. Pamphlet on IV Oxytocin for Induction and Augmentation of Labour- French
  9. ISMP Questions to Ask Tool on IV Oxytocin for Induction and Augmentation of Labour coming soon!

Other Resources

  1. HIROC Risk Reference Sheet – Failure to Communicate Fetal Status
  2. HIROC Risk Reference Sheet – Mismanagement of Induction Augmentation Medications

If you have any questions about this work, please contact Laura Zahreddine – Senior Program Manager, at Laura.Zahreddine@pcmch.on.ca.