Division Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht, the Netherlands; Danish Medicines Agency, Division of Pharmacovigilance and Medical Devices, Copenhagen, Denmark; Copenhagen Centre for Regulatory Science, Department of Pharmacy, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
Department of Intensive Care 4131, Rigshospitalet, Copenhagen, Denmark.
Int Emerg Nurs. 2021 Jul;57:101010. doi: 10.1016/j.ienj.2021.101010. Epub 2021 Jun 14.
Inappropriate fluid therapy may induce or worsen existing hyponatraemia with potentially life-threatening consequences. Nurses have an important role in assisting physicians in IV fluid prescribing. However, research is lacking in Denmark about nurses' knowledge pertaining to IV fluid therapy and hyponatraemia.
An explorative cross-sectional survey was performed among Danish emergency department nurses in Spring 2019. Knowledge about IV fluid therapy was assessed for three common clinical scenarios, and multiple-choice questions were used to measure knowledge about hyponatraemia.
112 nurses responded to all scenario questions corresponding to 6.2% (112/1815) of the total population of nurses working at emergency departments in Denmark. In two of the three scenarios, a minority of nurses (8-10%) inappropriately selected hypotonic fluids. Nearly one third (31%) selected a hypotonic fluid for a patient with meningitis, which is against guideline recommendations. The study revealed limited knowledge about severe symptoms of hyponatraemia, patients at high risk, and hyperglycaemia-induced hyponatraemia.
In accordance with guideline recommendation, the majority of nurses did not select hypotonic fluids in three clinical scenarios commonly encountered in the emergency department. However, when setting up an educational program, further awareness is needed regarding symptoms of hyponatraemia, high-risk patients, and hyperglycaemia-induced hyponatraemia.
不适当的液体疗法可能会导致或加重现有的低钠血症,从而带来潜在的危及生命的后果。护士在协助医生开具静脉输液处方方面发挥着重要作用。然而,丹麦缺乏关于护士在静脉输液治疗和低钠血症方面的知识的研究。
2019 年春季,在丹麦急诊科护士中进行了一项探索性的横断面调查。评估了三种常见临床情况的静脉输液治疗知识,并使用多项选择题来衡量对低钠血症的知识。
112 名护士对所有场景问题做出了回应,占丹麦急诊科工作的护士总数的 6.2%(112/1815)。在三个场景中的两个中,少数护士(8-10%)不恰当地选择了低渗液。近三分之一(31%)的护士选择低渗液治疗脑膜炎患者,这与指南推荐相违背。研究表明,护士对低钠血症的严重症状、高危患者和高血糖引起的低钠血症了解有限。
根据指南建议,在急诊科常见的三个临床场景中,大多数护士没有选择低渗液。然而,在制定教育计划时,需要进一步提高对低钠血症的症状、高危患者和高血糖引起的低钠血症的认识。