On-going lessons in fluid prescription: assessment of adherence to weight-based intravenous fluid prescribing in medical inpatients

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Introduction

Attention to detail in the prescription of intravenous (IV) fluids for medical and surgical inpatients is often less rigorous than for other drugs, with errors in fluid volume, composition and rate being commonplace.1–2

As part of a review of fluid prescribing and fluid balance we introduced a weight-based fluid prescribing policy, in a large adult teaching hospital. Including algorithms, this largely mirrors the recent NICE guidance (2014).1 Medical inpatients were prospectively assessed for adherence to local and subsequent national guidance, over four consecutive time points (May 2010, Spetember 2010, February 2013 and August 2014). Tailored education and campaigns were introduced. We report our findings, highlighting the ongoing problems in fluid prescribing.