Intravenous fluid selection rationales in acute clinical management

Area of Science:

• Medical Sciences
• Clinical Practice
• Healthcare Management

Background:

• Intravenous fluid (IVF) therapy is a cornerstone of acute clinical management.
• Understanding IVF prescription patterns and associated educational support is crucial for patient safety and effective care.

Purpose of the Study:

• To review the selection and primary considerations in intravenous fluid prescriptions.
• To evaluate the adequacy of existing guidelines and training for IVF prescription within Hong Kong's New Territories West Cluster (NTWC).

Main Methods:

• A descriptive online survey study was conducted.
• Participants (doctors and nurses) were presented with nine acute clinical scenarios to determine IVF choices and rationale.
• A 1-10 scale assessed the sufficiency of guidelines, training, information, and time for revision.

Main Results:

• 0.9% sodium chloride was the most familiar and frequently prescribed IVF (36%-61% across scenarios).
• Prescribing decisions were primarily driven by departmental practice.
• Guideline and training adequacy was rated average (5/10), suggesting a significant training deficit, with doctors reporting more time for knowledge updates than nurses.

Conclusions:

• 0.9% sodium chloride is the predominant IVF choice, often influenced by established departmental practices.
• The study highlights a significant training deficit regarding IVF prescription, with average ratings for guideline and training adequacy.
• There is a clear need to enhance educational resources and training programs for healthcare professionals on appropriate IVF selection.