PDSA practice guide Up to 9 CPD hrs

Aclasta infusion clinics

For practices with an osteoporosis cohort, an annual zoledronic acid infusion run in the practice keeps treatment where the patient already is. The guide covers the clinical protocol, pre-infusion pathology, consent, the nursing checklist and the recall system that brings patients back on schedule.

AuthorDr Chris Mitchell AM

CPD hoursUp to 9 CPD hrs

CycleOne quarter, Plan-Do-Study-Act

The nursing checklist and recall work give practice nurses a defined role in the cycle, and the hours they spend count toward their own NMBA requirement.

The worked example shows a practice identifying suitable patients, developing and approving a protocol, and embedding the service.

What the guide covers

Clinical protocol

Patient selection criteria, pre-infusion pathology thresholds, creatinine clearance calculation, infusion rate, observation schedule and the adverse-event pathway, with a traffic-light administration criteria table.

Consent and documentation

Informed consent content, Best Practice shortcuts, patient-facing advice and consumer medicines information, including the ONJ risk conversation at osteoporosis doses.

Nursing checklist and recall

Pre-infusion, in-the-chair and post-infusion checks, IV access, vital sign observations, the adverse reaction protocol and the annual recall that brings patients back on schedule.

CPD hours from this cycle

Up to 9 hours per participating GP when submitted as a practice-based or group activity: 3 hours educational activities, 3 hours reviewing performance, 3 hours measuring outcomes. Nurses record their participation toward the NMBA 20-hour requirement. A certified practice manager can claim the coordination work as professional development, on AAPM's conditions. The completed workbook is the supporting evidence.

Educational activities (3 hrs): Evidence review, bisphosphonate comparison, ONJ risk at osteoporosis doses and team education sessions.
Reviewing performance (3 hrs): Pre-infusion pathology audit, creatinine clearance and vitamin D review, and outcome tracking across infusions.
Measuring outcomes (3 hrs): The cycle itself: planning, implementation, reassessment and the changes embedded in practice workflows.

CPD figures verified against the guide and the CPD home handbooks, 15 July 2026.

The service case

Infusion fee

There is no dedicated MBS item for short-duration infusions in general practice. The usual arrangement is a private infusion fee plus a GP supervision fee, with zoledronic acid PBS-subsidised for qualifying indications.

Patient retention

Patients on annual infusion schedules rarely change practice once the service is established. The service keeps patients who would otherwise be sent to a day infusion unit or hospital clinic.

Key topics

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

Who this is for

Practice managers responsible for clinical governance documentation, nursing checklists, consent workflows and recall systems
GP practice owners and GPs introducing or formalising an in-house infusion service with a documented protocol and CPD outcome
Practice nurses, who run the checklist and recall work and log the hours toward the NMBA requirement

Choose your format

Open the interactive workbook

Type into it as you go; saves on your computer

Read the guide

Read online, print to PDF for your records

Download the PDF

A4 PDF for printing or your records

Author: Dr Chris Mitchell AM, FAICD, general practitioner and co-founder of Medius Global. This guide documents cycles run in his own practice. Editorial and review process.