Errors of intravenous fluid infusion rates in medical inpatients

Prescriptions for intravenous (i.v.) fluids in hospitals may not be closely adhered to. This study prospectively examined whether prescribed i.v. fluids are administered at the correct rate. During a four-week period, the i.v. infusion rates in patients requiring continuous i.v. fluids and cared for by a single medical team in a district hospital were studied. The periods over which i.v. crystalloid fluid bags were administered were compared with the time prescribed. Of a total 207 bags, 53 (26%) were correctly administered at the prescribed rate (percentage error 10% to -10%), 138 bags (67%) were infused too slowly and 16 bags (8%) were infused too fast. Overall, the median (interquartile range) absolute percentage error (positive or negative) for all infused bags was 23% (9.7-50). Thirty-nine per cent of bags were infused accurately when a metered pump was used, compared to 21% of bags infused accurately when a metered pump was not used (p < 0.01). Marked inaccuracies in i.v. fluid infusion rates are common, and do not seem to be perceived by staff as important. Metered pumps improve accuracy. Increased awareness of such errors, and the routine use of metered pumps should help improve the accuracy of i.v. fluid infusion rates.