A clinical audit of the intravenous fluid therapy given to hospitalised horses

Abstract

SummaryBackgroundThis audit was conducted as it was noted that intravenous fluid therapy (IVFT) was not as precise as anticipated. The aim was to enhance the precision of IVFT given to patients.ObjectivesTo (1) quantify the discrepancies in intravenous fluid administered to patients compared to prescribed volumes; (2) investigate causative factors, and develop an action plan to improve care quality and (3) assess the effectiveness of implemented changes.Study designA clinical audit was conducted. Clinical notes from horses receiving IVFT from January to June 2020 were analysed. Methods of improvement were discussed and implemented and a re‐audit was then conducted from January to June 2021.MethodsA 24‐h period was divided into a day‐time period from 08:00 AM to 18:00 PM and a night period from 18:00 PM to 08:00 AM and the prescribed fluid volume was compared to the actual volume administered to ICU patients during these periods. For the re‐audit, modifications were made, including the use of a modified analogue scale to quantify the remaining fluid volume in the bags, and revised recording sheets for intensive care and fluid therapy.ResultsIn 2020, 19/73 horses had records eligible for analysis. Horses received within 5 L of the prescribed volume in 14/53 (26%) time periods recorded. In 2021, 88/105 horses were eligible for data analysis. Horses received within 5 L of the prescribed volume in 156/220 (71%) time periods recorded. The Mann–Whitney U test was used to compare the difference in fluid volume prescribed and received between 2020 and 2021. The obtained p value of 0.0001295 revealed a significant difference between the 2 years, suggesting that the observed variation in fluid volume was not by chance.ConclusionsThe clinical audit facilitated demonstrable improvement and enhanced the standard of care.