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Related Experiment Video

Updated: Nov 22, 2025

A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings
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Surgical Fluid Prescribing: When Are the Last Orders?

Robert A Bennett1, George E Fowler1

  • 1General Surgery, Royal Devon and Exeter NHS Foundation Trust, Exeter, GBR.

Cureus
|January 7, 2021
PubMed
Summary

Foundation Year 1 doctors (FY1s) frequently receive fluid review requests, often initiated by nurses during shift changes. Improving education and multidisciplinary fluid prescribing practices can reduce inappropriate out-of-hours requests.

Keywords:
fluid therapygeneral surgeryjuniorout-of-hoursprescribing

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Area of Science:

  • Medical Education
  • Patient Safety
  • Surgical Care

Background:

  • Inappropriate fluid prescriptions contribute to surgical patient morbidity and mortality.
  • Foundation Year 1 doctors (FY1s) often exhibit poor fluid prescribing knowledge and habits.

Purpose of the Study:

  • To analyze the patterns and timing of out-of-hours (OOHs) fluid review requests in surgical patients.
  • To identify factors contributing to inappropriate fluid prescribing by FY1s.

Main Methods:

  • Retrospective observational study of 1,283 surgical fluid review requests over one year.
  • Data extracted from an out-of-hours electronic task record system at a district general teaching hospital.

Main Results:

  • 95.7% of fluid reviews were assigned to FY1s, and 92.3% were requested by nurses.
  • Requests peaked at 1900 and 2400, coinciding with nursing handovers and midnight fluid chart changes.

Conclusions:

  • Nursing staff frequently request fluid reviews during shift changes and at midnight.
  • Interventions targeting ward rounds and multidisciplinary education can improve fluid prescribing and reduce OOHs requests.