Rooker Jemma C, Gorard David A
Wycombe Hospital, High Wycombe.
Clin Med (Lond). 2007 Oct;7(5):482-5. doi: 10.7861/clinmedicine.7-5-482.
Prescriptions for intravenous (i.v.) fluids in hospitals may not be closely adhered to. This study prospectively examined whether prescribed i.v. fluids are administered at the correct rate. During a four-week period, the i.v. infusion rates in patients requiring continuous i.v. fluids and cared for by a single medical team in a district hospital were studied. The periods over which i.v. crystalloid fluid bags were administered were compared with the time prescribed. Of a total 207 bags, 53 (26%) were correctly administered at the prescribed rate (percentage error 10% to -10%), 138 bags (67%) were infused too slowly and 16 bags (8%) were infused too fast. Overall, the median (interquartile range) absolute percentage error (positive or negative) for all infused bags was 23% (9.7-50). Thirty-nine per cent of bags were infused accurately when a metered pump was used, compared to 21% of bags infused accurately when a metered pump was not used (p < 0.01). Marked inaccuracies in i.v. fluid infusion rates are common, and do not seem to be perceived by staff as important. Metered pumps improve accuracy. Increased awareness of such errors, and the routine use of metered pumps should help improve the accuracy of i.v. fluid infusion rates.
医院中静脉输液的处方可能未得到严格遵守。本研究前瞻性地考察了静脉输液是否按正确速率给药。在为期四周的时间里,对一家地区医院中由单一医疗团队护理的需要持续静脉输液的患者的静脉输液速率进行了研究。将静脉输注晶体液袋的时长与规定时间进行比较。在总共207袋输液中,53袋(26%)以规定速率正确给药(百分比误差在10%至 -10%之间),138袋(67%)输注过慢,16袋(8%)输注过快。总体而言,所有输注袋的中位(四分位间距)绝对百分比误差(正或负)为23%(9.7 - 50)。使用定量泵时,39%的输液袋输注准确,而未使用定量泵时,这一比例为21%(p < 0.01)。静脉输液速率存在明显不准确的情况很常见,而且工作人员似乎并未将其视为重要问题。定量泵可提高准确性。提高对此类误差的认识以及常规使用定量泵应有助于提高静脉输液速率的准确性。