329 An Audit into the Prescription of Maintenance IV Fluids for General Surgery Patients

Introduction Intravenous (IV) fluids are vital for maintaining surgical patients in a "nil by mouth" (NBM) state. They prevent dehydration, maintain electrolyte balance, support perfusion, provide nutrition, administer medications, stabilize blood pressure, monitor fluid balance, and address emergencies. The central objective of this audit is to assess the level of adherence to NICE guidelines in the surgical department concerning the prescription of IV fluids. Method During the pre-intervention phase, a two-week audit was conducted across three surgical wards where patients were in a nil by mouth (NBM) state. Each day, the audit involved a comprehensive review of patient records and drug charts. Additionally, inquiries were made with the respective nurses in charge to gather information on the IV fluids administered to the patients. The Intervention phase was also two weeks, across the same surgical wards. Intervention included a proforma and teaching to foundation doctors on the ward, to comply with NICE guidelines. Results The first cycle showed that no patients were given IV fluids according to NICE guidelines. The NICE guidelines state the following: According to the NICE guidelines, the recommended daily maintenance fluid requirements consist of:25-30 ml/kg/day of water,Approximately 1 mmol/kg/day of potassium, sodium, and chloride, andApproximately 50-100 g/day of glucose, primarily to prevent starvation ketosis (although it's important to note that this alone does not address the patient's nutritional needs). Second cycle is currently in progress, but early signs show a positive improvement Conclusions IV fluids are vital for maintaining "nil by mouth" patients.