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Greater vigilance for IV drip patients needed, says NICE

More must be done to prevent unnecessary deaths and other complications that emerge after clinicians make basic errors in prescribing drips to hospital patients, experts said.

Up to one in five patients could be suffering unnecessary complications because of “inappropriate administration” of intravenous (IV) fluid drips, the National Institute for Health and Care Excellence said.

And in rare cases these errors can lead to a patient dying, NICE warned today in a new quality standard for the NHS in England, which instructs how health workers can best treat people on drips in hospital.

IV fluids are one of the most commonly prescribed items in hospitals but patients are being put at risk because of complications associated with being given the wrong type of fluid and the over and under-prescribing of drips.

The new quality standard suggests that many medics do not know what they are doing when prescribing IV fluids.

It goes on to say that IV fluid management is often left to the most junior staff who “lack the relevant experience and may have received little or no specific training on the subject”.

NICE called for an IV champion to be installed in every hospital who will be responsible for best practice and training in fluid management.

Patients who are put on IV fluid must be cared for by a healthcare worker “competent” in the field, the institute added.

They should also have a fluid management plan, which is determined and reviewed by an expert, and any errors should be reported as “critical incidents”, the standard states.

NICE hopes that the new quality standard will help reduce the numbers of deaths or serious harms caused by inappropriate administration of the drugs and improve patient experience in hospital – including reducing the length of their stay.

Gillian Leng

“Our quality standards aim to help healthcare professionals in the NHS pinpoint the areas where improvements are most needed to provide the best care for patients,” said NICE’s deputy chief executive Professor Gillian Leng.

“With the new standard for IV fluid therapy, we hope to make sure that every patient, wherever they are, can be confident that they will be treated safely and effectively during their stay in hospital,” she said.

Readers' comments (2)

  • Hard to see how this can be achieved without safe staffing- which NICE declined to define

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  • different patients on different drip regimes on a 20-bed medical ward meant that they were being monitored round the clock. depending on the type of cannula, dressings were changed on average every other day and peripheral cannulae about once a week if there were no problems beforehand. we had very low infection rates but occasional phlebitis, tissueing, the fixation working its way loose and cannulae falling out or being pulled out by a confused patient. in the light of current research and in hindsight I would say there may have been overuse of iv antibiotics which tend to be administered in this manner in other European countries than in the UK but then standards of hygiene and standards of care are far higher in western European countries than in the UK.

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