title: Intravenous fluid use in the acutely unwell adult medical inpatient: improving practice through a clinical audit process.
abstract: BACKGROUND
  Our Trust developed a clinical guideline to improve the prescribing and use of intravenous (IV) fluids based on the British consensus guidelines on IV fluid therapy for adult surgical patients. We audited the effect of targeted interventions to improve performance against this guideline.
  
  
  METHODS
  There were 53 IV fluid prescription charts in the pre-intervention audit and 48 in the post-intervention audit. Data was collected on the seven local practice standards ('local gold standards') in the clinical guideline; compliance with all of them was necessary to meet the IV fluid prescribing bundle of care.
  
  
  RESULTS
  The proportion of prescriptions which met the IV fluid prescribing bundle of care increased (3.8% to 22.9% [p=0.004]) and the legibility of the IV fluid prescription increased (28.3% to 56.3% [p=0.004]).
  
  
  CONCLUSIONS
  We have shown that the process of prescribing, administering and monitoring IV fluid use can be significantly improved through a range of targeted multi-disciplinary interventions.
authors.affiliation: ACCS Training Programme, London, UK.
authors.forename: G E
authors.initials: GE
authors.lastname: Walker
authors.forename: E
authors.initials: E
authors.lastname: Stewart-Parker
authors.forename: S
authors.initials: S
authors.lastname: Chinthapalli
authors.forename: M
authors.initials: M
authors.lastname: Ostermann
authors.forename: P I
authors.initials: PI
authors.lastname: Dargan
authors.forename: D M
authors.initials: DM
authors.lastname: Wood
mesh_terms: D000328:Adult; D016638:Critical Illness / Q000628:therapy*; D005440:Fluid Therapy / Q000592:standards*; D019983:Guideline Adherence; D006760:Hospitalization; D006801:Humans; D007262:Infusions, Intravenous / Q000592:standards*; D008485:Medical Audit; D017410:Practice Guidelines as Topic; D055656:Prescriptions / Q000592:standards*; D058996:Quality Improvement; D006113:United Kingdom