Cheung Wing Yan Shirley, Cheung Wai Kwan, Lam Chun Ho, Chan Yeuk Wai, Chow Hau Ching, Cheng Ka Lok, Wong Yau Hang, Kam Chak Wah
Accident and Emergency Department, Tuen Mun Hospital, Hong Kong, China.
World J Emerg Med. 2018;9(1):13-19. doi: 10.5847/wjem.j.1920-8642.2018.01.002.
Intravenous fluid (IVF) is commonly used in acute clinical management. This study aimed to review the choice and primary considerations in IVF prescriptions and to evaluate the adequacy of guidelines and trainings on it in the New Territories West Cluster (NTWC) of Hong Kong.
This is a descriptive study based on data collected from an online survey. Data were processed by SPSS for statistical analysis. This study focused on a general description and doctor-nurse between group comparison. Participants were asked the choice of IVF for nine acute clinical scenarios and provide reason. A 1-10 scale was used to assess the sufficiency of guideline, training and information, and time for revision on IVF prescription.
0.9% sodium chloride was the most familiar IVF (36%), followed by 5% Dextrose solution (26%). In the nine scenarios, the most chosen IVF was 0.9% sodium chloride (37%-61%). There was significant difference in the choice of IVF between doctors and nurses in 7 cases. The second most chosen IVF for doctors was Plasma-Lyte A while that for nurses was Gelofusine. Departmental practice was the most chosen reason to account for the prescription. The adequacy of guideline, information and training, and time for revision was rated 5. Doctors had significantly more time at work than nurses to update knowledge in IVF prescription (5.41 versus 4.57).
0.9% sodium chloride was mostly chosen. The choice of IVF was mainly based on departmental practice. Adequacy of guideline, information and training, and time for revision on IVF prescription were average, indicating significant training deficit.
静脉输液常用于急性临床治疗。本研究旨在回顾静脉输液处方中的选择及主要考量因素，并评估香港新界西医院联网（NTWC）关于静脉输液的指南及培训是否充分。
这是一项基于在线调查收集数据的描述性研究。数据采用SPSS进行处理以进行统计分析。本研究重点在于总体描述以及组间医生与护士的比较。参与者被问及在九种急性临床场景下静脉输液的选择并给出理由。采用1至10分制评估静脉输液处方指南、培训及信息的充分性以及修订时间。
0.9%氯化钠是最常用的静脉输液（36%），其次是5%葡萄糖溶液（26%）。在这九种场景中，最常选用的静脉输液是0.9%氯化钠（37%-61%）。在7种情况下，医生和护士在静脉输液的选择上存在显著差异。医生第二常选用的静脉输液是平衡液，而护士是琥珀酰明胶。科室惯例是最常被提及的处方理由。指南、信息和培训的充分性以及修订时间的评分是5分。医生在工作中用于更新静脉输液处方知识的时间显著多于护士（5.41对4.57）。
0.9%氯化钠是最常被选用的。静脉输液的选择主要基于科室惯例。静脉输液处方指南、信息和培训的充分性以及修订时间处于中等水平，表明存在显著的培训不足。
