Walker G E, Stewart-Parker E, Chinthapalli S, Ostermann M, Dargan P I, Wood D M
ACCS Training Programme, London, UK.
J R Coll Physicians Edinb. 2012;42(3):211-5. doi: 10.4997/JRCPE.2012.304.
Our Trust developed a clinical guideline to improve the prescribing and use of intravenous (IV) fluids based on the British consensus guidelines on IV fluid therapy for adult surgical patients. We audited the effect of targeted interventions to improve performance against this guideline.
There were 53 IV fluid prescription charts in the pre-intervention audit and 48 in the post-intervention audit. Data was collected on the seven local practice standards ('local gold standards') in the clinical guideline; compliance with all of them was necessary to meet the IV fluid prescribing bundle of care.
The proportion of prescriptions which met the IV fluid prescribing bundle of care increased (3.8% to 22.9% [p=0.004]) and the legibility of the IV fluid prescription increased (28.3% to 56.3% [p=0.004]).
We have shown that the process of prescribing, administering and monitoring IV fluid use can be significantly improved through a range of targeted multi-disciplinary interventions.
我们的信托机构根据英国关于成人外科患者静脉输液治疗的共识指南，制定了一项临床指南，以改善静脉输液的处方和使用情况。我们审核了针对性干预措施对依据该指南提高绩效的效果。
干预前审核中有53份静脉输液处方图表，干预后审核中有48份。收集了临床指南中七个本地实践标准（“本地黄金标准”）的数据；必须符合所有标准才能达到静脉输液处方护理套餐要求。
符合静脉输液处方护理套餐要求的处方比例有所增加（从3.8%增至22.9% [p = 0.004]），静脉输液处方的清晰度也有所提高（从28.3%增至56.3% [p = 0.004]）。
我们已经表明，通过一系列有针对性的多学科干预措施，可以显著改善静脉输液使用的处方、给药和监测过程。
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