Errors in prescribing IV fluids and electrolytes are particularly likely in emergency departments, acute admission units, and general medical and surgical wards rather than in operating theatres and critical care units. Surveys have shown that many staff who prescribe IV fluids know neither the likely fluid and electrolyte needs of individual patients, nor the specific composition of the many choices of IV fluids available to them. Standards of recording and monitoring IV fluid and electrolyte therapy may also be poor in these settings. IV fluid management in hospital is often delegated to the most junior medical staff who frequently lack the relevant experience and may (5/10) have received little or no specific training on the subject.
- Chances of committing errors administering IV fluids and electrolytes are more in emergency departments than in operating theatres.
- No prescription errors happen in critical care units.
- Chances of prescription errors are less likely in general medical and surgical wards than in operating theatres and critical care units.
- Surveys have shown that majority of staff who prescribe IV fluids are unaware of the fluid to be administered
- Choices of IV fluids are limited.
- Standards of recording and monitoring IV fluid and electrolyte therapy is not same everywhere.
- IV fluid management in hospital is often delegated to the most junior medical staff who frequently lack the relevant experience.
The ‘National Confidential Enquiry into Perioperative Deaths’ report in 1999 highlighted that a significant number of hospitalised patients were dying as a result of infusion of too much or too little fluid. The report recommended that fluid prescribing should be given the same status as drug prescribing. Although mismanagement of fluid therapy is rarely reported as being responsible for patient harm, it is likely that as many as one in five patients on IV fluids and electrolytes suffer complications or morbidity due to their inappropriate administration.
- The report collected information about patient deaths during operation
- A large number of hospitalised patients died in 1999 as a result of infusion of too much or too little fluid.
- None of the patients who were not hospitalised died due to inappropriate fluid infusion.
- The report concluded that fluid prescribing and drug prescribing have equal importance.
- Mismanagement of fluid therapy rarely happens.
- Mismanagement of fluid therapy is reported.
- Mismanagement of fluid therapy causes patient harm but such occurrences are not reported.
- Inappropriate administration of IV fluids “causes” more harm than that of electrolytes.