1191 Assessing Fluid Prescriptions in Surgical Wards Within Wishaw Hospital

This is the authors' abstract. We don't add key points for this paper.

Aim There were discrepancies of intravenous (IV) fluids prescriptions on the surgical wards within Wishaw Hospital. This audit was conducted to ensure that 100% of IV fluids prescribed are based on accurate assessment of patients, as per NICE CKS guidelines. Method The audit was based off the classic 6 steps of an audit cycle. There were 2 rounds of data collection. This took place in general surgical wards in Wishaw Hospital in November 2022 and July 2023. Data collection comprised of assessing requirements of IV fluids & category of fluids required i.e., maintenance, resuscitation or replacement fluids. Thereafter assessing whether these fluids were correctly prescribed for each patient. Intervention was centred around an education session for staff, poster reminders and departmental presentation to increase awareness. Results A total of 836 fluid charts were reviewed across 2 audit cycles. First round of data collection yielded 43% of IV fluids were correctly prescribed, whereas second round of data collection had shown a 24% improvement. Reasons of incorrectly prescribed fluids mainly comprises of administering fluids at the wrong rate or having wrong type of fluids prescribed, which has, overall, decreased in incidence in the second cycle. Conclusions There was a substantial improvement in fluid prescriptions, however, it is imperative to continue these efforts to improve fluid prescription as, inappropriate fluid prescriptions is associated with higher post-operative mortality. Mandatory teaching sessions on IV fluids should be delivered at the start of each rotation block. Further intervention can include addressing IV fluids more thoroughly in medical school.