Heslop Calum, Rajpara Milap, Wood Sally, Patel Talia, Karelia Shivaali, Patel Rakesh
Specialised Foundation Programme Doctor, Liverpool University Hospitals, Liverpool.
Foundation Year 2 Doctor, University Hospitals of Leicester, Leicester.
Br J Nurs. 2024 Jul 18;33(14):S16-S24. doi: 10.12968/bjon.2024.0091.
Foundation doctors and nurses are the clinicians most closely involved in fluid assessment, intravenous (IV) fluid prescription and administration. However, both groups report challenges regarding IV fluids. At a large NHS trust in England, adherence to the National Institute for Health and Care Excellence (NICE) guideline CG174, regarding IV fluids, was largely unknown.
To assess the baseline adherence, within the hospitals, to CG174 and identify areas for improvement.
A set of 12 audit standards were developed and used to collect data across 29 clinical areas between September 2022 and May 2023, with 255 patients receiving IV fluids at any time during their inpatient stay included.
For two standards target adherence of 95% was achieved, with an adherence less than 50% in most. Areas of particularly poor adherence included assessing and meeting fluid and electrolyte requirements, patient reassessment and developing IV fluid management plans.
Trust baseline adherence to NICE CG174 requires improvement, particularly regarding patient assessment and reassessment, and meeting electrolyte requirements.
住院医师和护士是最直接参与液体评估、静脉输液处方及给药的临床医生。然而，这两类人员均表示在静脉输液方面面临挑战。在英格兰一家大型国民保健服务信托机构中，对于静脉输液，遵循英国国家卫生与临床优化研究所（NICE）指南CG174的情况基本无人知晓。
评估医院内部对CG174的基线遵循情况，并确定改进领域。
制定了一套12项审核标准，并于2022年9月至2023年5月期间用于收集29个临床领域的数据，纳入了255名在住院期间随时接受静脉输液的患者。
两项标准的目标遵循率达到了95%，而大多数标准的遵循率低于50%。遵循情况特别差的领域包括评估并满足液体和电解质需求、对患者进行重新评估以及制定静脉输液管理计划。
信托机构对NICE CG174的基线遵循情况需要改进，尤其是在患者评估与重新评估以及满足电解质需求方面。
