Nurses' Self-Reported Practices and Prescribers' Expectations in Intravenous Fluid Therapy for Hospitalised Patients: A Survey Study and Clinical Documentation Review.

Λεπτομέρειες βιβλιογραφικής εγγραφής
Τίτλος:	Nurses' Self-Reported Practices and Prescribers' Expectations in Intravenous Fluid Therapy for Hospitalised Patients: A Survey Study and Clinical Documentation Review.
Συγγραφείς:	Spoon D; Department of Internal Medicine, Section Nursing Science, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands., Ista E; Department of Internal Medicine, Section Nursing Science, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.; Division of Pediatric Intensive Care, Department of Neonatal and Pediatric Intensive Care, Erasmus MC - Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, the Netherlands., van der Zanden M; Department of Internal Medicine, Section Nursing Science, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands., van Dijk M; Department of Internal Medicine, Section Nursing Science, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.; Division of Pediatric Intensive Care, Department of Neonatal and Pediatric Intensive Care, Erasmus MC - Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, the Netherlands., Berger E; Franciscus Academy, Franciscus Gasthuis & Vlietland, Rotterdam, the Netherlands., den Uil C; Department of Intensive Care Medicine, Maasstad Hospital, Rotterdam, the Netherlands.; Department of Intensive Care Medicine, Van Weel-Bethesda, Dirksland, the Netherlands.; Department of Intensive Care Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands., Alsma J; Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.
Πηγή:	Journal of advanced nursing [J Adv Nurs] 2026 Jun; Vol. 82 (6), pp. 5951-5966. Date of Electronic Publication: 2025 Sep 11.
Τύπος έκδοσης:	Journal Article; Multicenter Study
Γλώσσα:	English
Στοιχεία περιοδικού:	Publisher: Blackwell Scientific Publications Country of Publication: England NLM ID: 7609811 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1365-2648 (Electronic) Linking ISSN: 03092402 NLM ISO Abbreviation: J Adv Nurs Subsets: MEDLINE
Imprint Name(s):	Publication: Oxford : Blackwell Scientific Publications Original Publication: Oxford, Blackwell.
Ιατρικοί όροι (MeSH):	Fluid Therapy/nursing , Nursing Staff, Hospital/psychology , Nursing Staff, Hospital/statistics & numerical data , Practice Patterns, Nurses'/statistics & numerical data, Humans ; Cross-Sectional Studies ; Female ; Male ; Adult ; Surveys and Questionnaires ; Middle Aged ; Netherlands ; Self Report ; Retrospective Studies ; Infusions, Intravenous ; Documentation ; Aged
Περίληψη:	Aims: To assess self-reported practices and knowledge of nurses and prescribers (i.e., physicians and nurse practitioners) on intravenous fluid therapy, and to evaluate how this is documented through a clinical documentation review. Design: Multicentre cross-sectional study, between April 2022 and July 2022, across 13 wards from four Dutch hospitals. Methods: A survey study was conducted to assess self-reported practices related to intravenous fluid therapy. A 12-item questionnaire evaluated knowledge. To gain insights into documentation practices, a retrospective chart review was performed. Data analysis involved descriptive statistics, with group differences analysed using the chi-squared test or Fisher's exact test, as appropriate. Results: Three hundred and four healthcare professionals completed the questionnaire (92% nurses). The majority of prescribers (n = 20/25; 80%) expected that nurses would start, stop or change intravenous fluid therapy. Overall, the median number of correct answers to knowledge questions was eight (IQR 7-9, range 0-12); four participants (1%) answered all knowledge questions correctly. Knowledge about the composition of sodium chloride 0.9% solution was limited. Analysis of patient charts revealed that 54% (196/362) received intravenous fluids, most commonly 0.9% sodium chloride infusion (168/195; 86%), although the indication was described in 3% (6/196). Thirty-one percent (61/196) of patients received intravenous fluids to keep the vein open (< 30 mL/h). Conclusion: The study identified shared responsibility, a knowledge gap, and limited documentation concerning intravenous fluids. Prescribers expect nurses to adjust intravenous fluids without consulting a prescriber, which aligns with what nurses do, although they are not legally authorised. Given the limited documentation of the indication for intravenous fluids, it is plausible that several patients received intravenous fluids unnecessarily. Implications: The perceived shared responsibility presents an opportunity to develop a protocol engaging both prescribers and nurses, aiming to guide more targeted infusion therapy. Impact: Reducing unnecessary infusions to keep-the-vein-open can help eliminate low-value care. Reporting Method: CROSS guideline. Patient or Public Contribution: No patient or public contribution. (© 2025 The Author(s). Journal of Advanced Nursing published by John Wiley & Sons Ltd.)
References:	J Perianesth Nurs. 2019 Aug;34(4):717-728. (PMID: 30827790) Epidemiologia (Basel). 2022 Dec 31;4(1):18-32. (PMID: 36648776) Intensive Care Med. 2023 Jan;49(1):65-74. (PMID: 36480046) BMJ Qual Saf. 2018 Nov;27(11):892-901. (PMID: 29627799) J Adv Nurs. 2026 Jun;82(6):5951-5966. (PMID: 40931896) J Infus Nurs. 2016 Jan-Feb;39(1):32-7. (PMID: 26714117) J Crit Care. 2022 Oct;71:154122. (PMID: 35908420) BMJ Qual Improv Rep. 2014 Nov 03;3(1):. (PMID: 26734287) Crit Care Nurse. 2013 Feb;33(1):25-35. (PMID: 23377155) Int J Clin Pharm. 2025 Feb;47(1):136-145. (PMID: 39527169) AACN Adv Crit Care. 2020 Dec 15;31(4):364-370. (PMID: 33313703) Intensive Care Med. 2023 Dec;49(12):1529-1530. (PMID: 37843573) JAMA Intern Med. 2018 Sep 1;178(9):1201-1208. (PMID: 30014139) Perioper Med (Lond). 2015 Apr 10;4:3. (PMID: 25897397) Eur J Pediatr. 2022 Aug;181(8):3163-3172. (PMID: 35503578) J Clin Pharm Ther. 2015 Oct;40(5):489-495. (PMID: 26096723) J Eval Clin Pract. 2022 Aug;28(4):599-606. (PMID: 35080261) Int J Surg. 2018 Mar;51:199-204. (PMID: 29407251) Int J Clin Pharm. 2012 Apr;34(2):374-81. (PMID: 22392405) Arch Dis Child. 2015 Jul;100(7):700-3. (PMID: 25589559) Ann Intensive Care. 2020 May 24;10(1):64. (PMID: 32449147) Br J Anaesth. 2018 Feb;120(2):376-383. (PMID: 29406186) Br J Anaesth. 2014 Nov;113(5):740-7. (PMID: 25204700) Stud Health Technol Inform. 2016;225:979-80. (PMID: 27332441) J Nephrol. 2017 Aug;30(4):485-492. (PMID: 27900717) J Family Med Prim Care. 2020 Dec 31;9(12):6073-6077. (PMID: 33681043) Int Emerg Nurs. 2021 Jul;57:101010. (PMID: 34139392) PLoS One. 2018 Feb 28;13(2):e0193436. (PMID: 29489908) Indian J Med Res. 2008 Jun;127(6):577-81. (PMID: 18765877) Nefrologia (Engl Ed). 2021 Nov-Dec;41(6):605-611. (PMID: 36165149) Perspect Med Educ. 2017 Dec;6(6):369-379. (PMID: 29119469) Intensive Crit Care Nurs. 2015 Dec;31(6):352-8. (PMID: 26292919) Lancet Infect Dis. 2020 Jul;20(7):864-872. (PMID: 32151333) Int J Nephrol Renovasc Dis. 2020 Sep 30;13:219-230. (PMID: 33061531) Surgery. 2021 Aug;170(2):532-540. (PMID: 33712307) Lancet. 2017 Jul 8;390(10090):156-168. (PMID: 28077234) Cochrane Database Syst Rev. 2003;(4):CD004423. (PMID: 14584013) J Infus Nurs. 2018 May/Jun;41(3):165-169. (PMID: 29659463) JAMA Health Forum. 2022 Jan 14;3(1):e214543. (PMID: 35977230) Am J Kidney Dis. 2014 Apr;63(4):700-12. (PMID: 24332766)
Contributed Indexing:	Keywords: hospital; intravenous fluid therapy; low value care; nurses/nursing care
Entry Date(s):	Date Created: 20250911 Date Completed: 20260515 Latest Revision: 20260813
Update Code:	20260813
PubMed Central ID:	PMC13176734
DOI:	10.1111/jan.70216
PMID:	40931896
Βάση Δεδομένων:	MEDLINE

Full Text Finder

Περιγραφή
ISSN:	1365-2648
DOI:	10.1111/jan.70216