title: Postoperative electrolyte management: Current practice patterns of surgeons and residents.
abstract: BACKGROUND
  Managing postoperative electrolyte imbalances often is driven by dogma. To identify areas of improvement, we assessed the practice pattern of postoperative electrolyte management among surgeons and residents.
  
  
  METHODS
  An online survey was distributed among attending surgeons and surgical residents at the University of Toronto. The survey was designed according to a systematic approach for formulating self-administered questionnaires. Questions addressed workload, decision making in hypothetical clinical scenarios, and improvement strategies.
  
  
  RESULTS
  Of 232 surveys distributed, 156 were completed (response rate: 67%). The majority stated that junior residents were responsible for managing electrolytes at 13 University of Toronto-affiliated hospitals. Supervision was carried out predominately by senior residents (75%). Thirteen percent reported management went unsupervised. Approximately 59% of residents were unaware how often attending surgeons assessed patients' electrolytes. Despite the majority of residents (53.7%) reporting they were never given tools or trained in electrolyte replacement, they considered themselves moderately or extremely confident. The management of hypothetical clinical scenarios differed between residents and attending surgeons. The majority (50.5%) of respondents considered that an electrolyte replacement protocol is the most appropriate improvement strategy.
  
  
  CONCLUSIONS
  Electrolyte replacement represents an important component of surgeons' workload. Despite reporting that formal training in electrolyte management is limited, residents consider themselves competent; however, their practice is highly variable and often differs from pharmacologic-directed recommendations. Optimizing how postoperative electrolytes are managed in surgical wards requires building a framework that improves knowledge, training, and limits unnecessary interventions.
authors: Division of General Surgery, Department of Surgery, University of Toronto, Toronto, ON, Canada.
authors: Fernando A
authors: FA
authors: Angarita
authors: Division of General Surgery, Department of Surgery, University of Toronto, Toronto, ON, Canada; The Division of Vascular Surgery, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
authors: Andrew D
authors: AD
authors: Dueck
authors: Division of General Surgery, Department of Surgery, University of Toronto, Toronto, ON, Canada. Electronic address: azouzmd@gmail.com.
authors: Solomon M
authors: SM
authors: Azouz
mesh_terms: D005440:Fluid Therapy; D019538:Health Care Surveys; D006801:Humans; D007396:Internship and Residency; D008505:Medical Staff, Hospital; D011182:Postoperative Care / Q000379:methods*; D010818:Practice Patterns, Physicians'; D011795:Surveys and Questionnaires; D014882:Water-Electrolyte Balance