PT  - JOURNAL ARTICLE
AU  - Sidonie Hartridge-Lambert
AU  - Lorna Moore
AU  - Oliver Walker
AU  - Dominic Wilkinson
TI  - Improving out-of-hours intravenous fluid prescribing for junior doctors: a prescription label
AID  - 10.1136/bmjquality.u632.w638
DP  - 2013 Jan 01
TA  - BMJ Quality Improvement Reports
PG  - u632.w638
VI  - 2
IP  - 1
4099  - http://bmjopenquality.bmj.com/content/2/1/u632.w638.short
4100  - http://bmjopenquality.bmj.com/content/2/1/u632.w638.full
SO  - BMJ Qual Improv Report2013 Jan 01; 2
AB  - Junior doctors are routinely asked to prescribe intravenous fluids (IVF) out-of-hours. Given time constraints and the number of unfamiliar patients, there is uncertainty about their prescription accuracy and safety, particularly in patients who have specific fluid balance requirements. An IVF prescription label was devised for the fluids section of the adult drug chart indicating important patient identifiers and diagnoses such as chronic heart/renal failure. The audit was carried out over a 16 day period, covering three weekends. A qualitative pre- and post-audit questionnaire assessed the confidence of junior doctors in out-of-hours IVF prescribing. All doctors based on the ward during that specific time period were targeted for the post-audit questionnaire. Post-audit, 58% (n=7) saw the label. 86% of those seven doctors stated the label had prompted them to do the following: a) examine the patient b) check blood results and c) urine output. 100% stated that the label improved their confidence in prescribing IVF. In addition, 71% felt the label made them more cautious in prescribing IVF and 43% felt they prescribed less. Overall, all seven (100%) doctors stated that the IVF prescription label was a useful addition to the drug chart. In conclusion, pressurised junior doctors would feel more confident prescribing IVF for unfamiliar patients if crucial information was readily visible on the drug chart. This would improve the accuracy of fluid prescribing and patient safety.