A Clinical Audit on Appropriateness of Intravenous Fluid Prescribing Practices in Hospitalized Adult Inpatients: Evaluating Compliance with National Guidelines
DOI:
https://doi.org/10.53350/pjmhs02025193.7Keywords:
Intravenous fluid therapy, clinical audit, prescribing practices, guideline complianceAbstract
Background: Intravenous (IV) fluid therapy is a routine yet critical aspect of inpatient care, essential for maintaining fluid and electrolyte balance. However, inappropriate prescribing can result in significant morbidity.
Aim: To assess appropriateness of IV fluid prescribing practices among adult inpatients at Lady Reading Hospital, Peshawar & evaluate compliance with NICE CG174 guidelines.
Methods: A retrospective audit was conducted over six months (January–June 2024). Data were collected from 200 randomly selected patient records across general medicine, surgery, and orthopedics departments. A structured tool based on NICE guidelines was used to evaluate key parameters such as initial fluid assessment, documentation, reassessment, and fluid type. Data were analyzed using SPSS version 25.
Results: Only 48% of IV fluid prescriptions were fully compliant with NICE guidelines; 35% were partially compliant, and 17% were non-compliant. Documentation of initial assessment occurred in 70% of cases, while ongoing reassessment was documented in just 49%. General Medicine showed the highest compliance (55%), and Orthopedics the lowest (38%). Normal Saline was the most frequently prescribed fluid (65%).
Conclusion: The audit reveals suboptimal adherence to national guidelines, with notable interdepartmental variation. Targeted interventions, including staff training and standardized protocols, are recommended to enhance safe and effective fluid prescribing practices.
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Copyright (c) 2025 NAQEEB ULLAH, ZEESHAN UMAR, SYED HUSSAINI SHAH, SYED HASSNAIN SHAH, WAJID ALI, SANA MUKHTIAR, SAJID NAWAZ, TAMANNA NAZIR, HANIF ULLAH HANFI, SHEEMA IQBAL, ZUBAIR AHMAD
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