595 Audit of IV fluids prescription and administration on adult surgical in-patients
Mohammed Babiker, Joseph Garnett, Angus Dawson, Omar Hassoun, Keira Jones, Jeyakumar Apollos, Magnus Johnston- Surgery
Abstract
Aim
Is to measure the conformity of the practice with the guidelines issued by NICE (National Institute for Health and Care Excellence), GIFTASUP (Guidance on Intravenous Fluid Therapy for Adult Surgical Patients) and the local hospital policies.
Methods
NICE guidelines and GIFTASUP recommendations were reviewed. Data collected from medical records of 40 in-patients on surgical wards. The records with incomplete information were excluded from the analysis. The data was then analyzed using Excel sheets, and the results were reviewed and compared against the guidelines mentioned above. The variables measured during the audit were the level of prescriber, indications, type of fluid, rate of administration, pre-checking of U/Es, and complications.
Results
The results showed that the majority of the IV fluids were prescribed by FY1s (40%) and ANPs (20%). The majority of the prescriptions were for maintenance purposes (63%). The most commonly used fluid was 0.18% NaCL/4% Dextrose (35%) followed by Hartmann's (30%). The most common rate of administration was 150ml/hr (35%) and only 10% of the U/Es were pre-checked. The commonest complication recorded was hypo-natraemia (15%), followed by hypo-kalaemia (5%) and total 25% of patients suffered complications.
Conclusion
The audit revealed that there were issues with documentation, type of fluids used and the rate of administration and complications. These findings can be used to improve the practice of IV fluid prescription and administration, ensuring that it is in line with the guidelines and policies, resulting in better patient outcomes.