Audit on intravenous fluid in children at a teaching hospital in North East England

Objectives: To compare the current practice of intravenous fluid regime usage in children from one month to 16 years at University Hospital of North Tees and University Hospital of Hartlepool against local guideline developed using National Patient Safety Agency (NPSA) guideline. A subsidiary objective was to identify desirable changes that need to be done to the existing system.

Method: E-discharge letters were perused from 1^st January to 31^st December 2009. Children who received intravenous fluid were taken and detailed discharge letters were screened. A pretested proforma was used to audit the discharge notes.

Results: During the one year period 62 patients were included. Fifty two percent were males. Twenty eight children were less than one year old, 24 between 1-5 years, 6 between 6-10 years and 4 more than 10 years old. Complete clinical data to assess dehydration was not recorded according to audit standard in any of the patients. Clinical diagnoses were gastroenteritis in 14, viral illness in 10, bronchiolitis in 8 and pyloric stenosis in 6. Mild dehydration was noted in 52, moderate dehydration in 4 and severe dehydration in 2.

Compliance on the guideline was audited during different stages of management. Forty percent guideline compliance was achieved during immediate resuscitation, 71% during maintenance fluid, 50% during fluid deficit correction, 0% during replacement of on-going losses, 78% during monitoring of electrolytes and 6% during monitoring of fluid balance.

Conclusion: This audit showed that audit standards were not achieved at different levels of management.

(Key words: clinical audit, intravenous fluid management)

DOI: http://dx.doi.org/10.4038/sljch.v41i3.4602