title: Introducing a clinical pathway in fluid management.
abstract: Following the publication of the National Confidential Enquiry into Perioperative Death's (NCEPOD) report, Extremes of Age (NCEPOD 1999), several recommendations were made relating to the management of patients admitted via Accident and Emergency (A&E) with fractured necks of femur (NOF). An audit was carried out relating fluid management in the elderly. A multidisciplinary clinical pathway for patients with fractured NOF was produced. The audit was repeated in 2002, 2003 and 2005 to obtain data as to whether the pathway had improved the management of patients admitted with fractured NOF Comparing audit data between 2000 and 2005 there were significant reductions in the incidence of perioperative hypotension and an increase in the percentage of patients who were prescribed and received intravenous fluids (p<0.05). A protocol-based pathway produced as a result of a recommendation from NCEPOD has greatly improved the fluid management of patients admitted to a general hospital with fractures.
authors.affiliation: St Mary's Hospital, Paddington.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Davidson
authors.forename: Richard
authors.initials: R
authors.lastname: Griffin
authors.forename: Simon
authors.initials: S
authors.lastname: Higgs
mesh_terms: D000368:Aged; D002985:Clinical Protocols; D019091:Critical Pathways / Q000458:organization & administration*; D004638:Emergency Treatment / Q000379:methods* / Q000451:nursing / Q000592:standards; D004739:England / Q000453:epidemiology; D005265:Femoral Neck Fractures / Q000401:mortality / Q000628:therapy*; D005440:Fluid Therapy / Q000379:methods* / Q000592:standards; D017052:Hospital Mortality; D006769:Hospitals, General; D006801:Humans; D007022:Hypotension / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D015994:Incidence; D007431:Intraoperative Complications / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D007902:Length of Stay / Q000706:statistics & numerical data; D008485:Medical Audit; D010348:Patient Care Team / Q000458:organization & administration*; D012151:Resuscitation / Q000379:methods* / Q000592:standards; D012189:Retrospective Studies; D017749:Total Quality Management