Out of hours intravenous fluid therapy: a prompt to guide prescribing

• DOI: 10.1136/bmjquality.u204010.w3139
• Publication Date: 2015-02-13T05:34:58Z
• Authors: Janev Fehmi; Alexander Carpenter; Matthew Townsend; Rhian Sheppeard; Elizabeth Gannon; Lynsey Hewitson; Natalie Auerbach; Katherine Thomas
• Keywords: Intravenous fluid; SAFER; Nice; Intravenous Infusions

Recent NICE guidance has highlighted the importance of appropriate and safe intravenous fluid use. We aimed to improve quality out hours prescription in a Bristol hospital by ensuring that indications cautions for therapy were clearly documented at time initiation. Time-pressured on-call doctors need quick access information regarding patients' care. A "fluid plan" allows undertake more informed assessment patient's balance, leading safer prescriptions. Our ideal was 100% prescriptions be appropriate. process measures included proportion patients on fluids who had plan medical notes or chart Friday, prior weekend call period. This defined as mention and/or therapy. The introduction sticker prompt documentation did marginally use plans. It notable 96% these followed where plans (n=23). Initiation IV with an accompanying is likely make subsequent safer. Rapid turnover staff stationary proved significant barriers consistent implementation sticker. Despite challenges we demonstrated "proof concept", suggesting system modification include effective.