944 Re Audit: Maintenance Iv Fluids Prescribing. (19th August 2022)

• Record Type: Journal Article
• Authors: Sehrazi, SAR; Koroma, P; Shetty, VD
• Is Part Of: British journal of surgery. Volume 109(2022)Supplement 6
• Publication Date: 2022-08-19
• Subjects: Surgery -- Periodicals; 617.005
• DOI: 10.1093/bjs/znac269.049
• Languages: English
• ISSNs: 0007-1323

Abstract

Abstract: Aim: Many hospital admissions require intravenous (IV) fluid therapy to prevent or correct fluid status and/or electrolyte disturbances. Within our trust the recommended IV maintenance fluid is 0.18% Saline in Glucose 4%. This Re audit aimed to assess the knowledge and improve understanding of junior clinicians for IV maintenance fluid prescribing at Royal Preston Hospital by comparing our current practice to Trust guidelines/NICE guidelines Method: A multiple choice knowledge questionnaire was used evaluate the knowledge of foundation doctors, core trainee's and advanced care practitioners (n=21). The trusts electronic system was used to review patients prescribed maintenance fluid. (n=50). 1st audit was conducted in October 2020 followed by re audit in April 2021. Results: In 1st cycle only 16% of the patients had the recommended maintenance fluid prescribed. We displayed posters and sent email reminders of the trust IV fluid prescribing guidelines. Junior's knowledge of the IV fluid prescribing guidelines improved regarding: recommended maintenance fluid (52% to 80%), Daily fluid requirement in ml/kg/day (66% to 70%) and Recommended monitoring (52% to 100%). This ultimately led to the prescribing of 0.18% Saline in Glucose 4% in 38% of patients. Plasma-Lyte remained the most commonly fluid prescribed in both audit cycles (42% vs 50%). Conclusion: Changes implemented after 1st cycle led to improvement is prescribing fluid of choice but there is still room for improvement. Juniors report consultant lead decisions influencing their prescribing and the availability of fluids on the wards.