Intravenous fluid administration and monitoring for adult ward patients in a teaching hospital

Abstract

Many acutely unwell, hospitalized patients receive continuous intravenous (IV) fluids. Complications of IV fluid administration include electrolyte abnormalities and fluid overload, which be detected by appropriate IV fluid administration and monitoring practices. This prospective clinical audit described the administration and monitoring of maintenance IV fluid in ward patients in an Australian tertiary teaching hospital. Of 332 inpatients (98%), 85 (26%) were receiving IV fluids. Serum electrolyte and renal function measurements were obtained in 85% versus 65% of patients receiving IV fluids versus no IV fluids (P < 0.001). Fluid balance charts were being maintained for 94% versus 44% of patients receiving IV fluids versus no IV fluids (P < 0.001). Body weight measurements were documented for 15% versus 14% for patients receiving IV fluids versus no IV fluids (P = 0.078). Findings show that approximately one-quarter of adult ward patients in our hospital received IV fluids. Monitoring of such patients using regular blood tests and fluid balance charts is high, but patient weight measurements are low. Why hospitalized patients who require maintenance IV fluids do not have regular body weight measurements requires further investigation.