CPD PDSA guide
A worked PDSA cycle for introducing zoledronic acid infusion as a practice service, building the clinical protocol, and meeting CPD requirements as a whole practice team.
Osteoporosis is one of the most common chronic conditions in general practice, and the clinical endpoint that matters is a fragility fracture. Despite this, osteoporosis is underdiagnosed and under-treated in Australia, and many patients who meet PBS criteria for pharmacologic therapy are either on no treatment or on a regimen they struggle to maintain.
This guide takes your practice team through a complete Plan-Do-Study-Act (PDSA) cycle focused on introducing Aclasta (zoledronic acid) infusions as an in-house service. It covers patient selection, pre-infusion pathology, clinical protocol development, consent, nursing checklists and recall logic. The worked example shows how a real practice identified suitable patients, developed and approved a protocol, and embedded the service.
Completing the full cycle can contribute up to 9 Continuing Professional Development (CPD) hours across Educational Activities, Reviewing Performance and Measuring Outcomes categories when submitted as a practice-based or group activity.
Patient selection criteria, pre-infusion pathology thresholds, creatinine clearance calculation, infusion rate, observation schedule and adverse-event pathway. Includes a traffic-light administration criteria table.
Informed consent content, Best Practice shortcuts (ACLASTADR), patient-facing advice and consumer medicines information. Covers the ONJ risk conversation at osteoporosis doses.
Pre-infusion, in-the-chair and post-infusion nursing checklist. IV access, vital sign observations and adverse reaction protocol. Annual recall setup for ongoing doses.
Completing the full PDSA cycle can contribute up to 9 CPD hours. The breakdown below shows how hours are allocated across RACGP CPD categories.
Evidence review, bisphosphonate comparison, ONJ risk at osteoporosis doses, clinical protocol development and team education sessions.
Pre-infusion pathology audit, creatinine clearance and vitamin D status review, outcome tracking across infusions.
The PDSA cycle itself: planning, implementation, reassessment and documentation of changes embedded in practice workflows.
Patient identification and osteoporosis audit
Pre-infusion pathology and safety thresholds
Infusion protocol and nursing procedure
PBS eligibility and billing structure
Consent, ONJ risk and adverse-event management
Unlike cost-avoidance topics, Aclasta infusion is a revenue-generating service that also builds patient retention.
There is no dedicated MBS item for short-duration infusions in general practice. Practices typically charge a private infusion fee plus a GP supervision fee. Zoledronic acid is PBS-subsidised for qualifying indications.
Patients on annual infusion schedules rarely change practice once the service is established. The service captures patients who would otherwise be sent to a day infusion unit or hospital clinic.
This PDSA guide is free for Australian GP practices.