Improving intravenous fluid prescribing

Intravenous (IV) fluid therapy is integral to the care of patients in hospitals but involves complex decisions. Errors in fluid prescribing are common, leading to significant harm due to inappropriate fluid type, rate or volume. British national guidelines have been developed to improve prescribing, but adherence has been generally poor. The Scottish Government has set up a National IV Fluid Improvement Programme to implement national guidelines throughout Scotland.

Addressing prescription discrepancies in renal patients: a prospective audit


Background Management of chronic renal failure requires complex medication regimens to manage hypertension, hyperlipidaemia, diabetes, phosphate, anaemia and acidosis. Patient engagement in medicine management is essential to avoid potential harm.

Methods We prospectively audited the rate of discrepancies between our hospital record of patient medications and their current prescription. We investigated whether changes to appointment letters reduced the number of discrepancies.

Bisphosphonate prescribing in chronic kidney disease

Osteoporosis and chronic kidney disease (CKD) are both increasingly prevalent with advancing age. Bisphosphonates are licensed for use in osteoporosis, but the appropriateness and safety of this class of drug in CKD is uncertain. This study assessed the use of bisphosphonates for persons with CKD in clinical practice. The prescribing pattern of bisphosphonates in all 595 persons attending renal services in one UK hospital was analysed.

Intravenous fluid use in the acutely unwell adult medical inpatient: improving practice through a clinical audit process

Background: Our Trust developed a clinical guideline to improve the prescribing and use of intravenous (IV) fluids based on the British consensus guidelines on IV fluid therapy for adult surgical patients. We audited the effect of targeted interventions to improve performance against this guideline.