Background and aims Practice of prescribing IV fluids in hospitals is invariably left to most junior doctors. Only 16% of surgical consultants feel that junior doctors are appropriately educated in regard to IV fluid prescribing. NICE in December 2013 introduced a guideline for intravenous fluid therapy which was later updated.
Methods We audited the practice of prescribing IV fluids in our hospital against the 10 standards of the NICE guideline. We randomly selected 40 adult in-patients (20 medical and 20 surgical) who were on intravenous fluid therapy for at least 24 hours. Medical and nursing notes and prescription charts were assessed as to their compliance with audit standards.
Results The compliance of IV fluid therapy was found to be very poorly compliant with the NICE guideline. Only 29% of 10 standards were found to be >90%. Few recommendations were made based on the results. We decided to develop a new IV fluid policy for our hospital. We planned to put together teaching sessions for junior doctors and nursing staffs. We decided to develop more user friendly IV fluid chart integrated with current drug chart. All IV fluids need to be infused via pump. We developed a task team to implement all these recommendations. After a series of meeting including anaesthetists, medical team, nurses and pharmacy, we managed to accomplish an action plan.
Conclusions Intravenous fluid therapy is very important part of treatment of patients in hospital. Auditing the practice of IV fluid therapy helps in improving the standards.
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