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Vascular Access/IV

Understanding nursing perceptions of intravenous fluid management practices

27 July 2023

Canadian Vascular Access Association

02 July 2023

Volume 32 · Issue 14

ISSN (print): 0966-0461

ISSN (online): 2052-2819

Abstract

Purpose:

Intravenous (IV) fluids are routinely used in hospitalized patients. As IV fluids are an everyday occurrence, their importance is often overlooked. Many patients receive large volumes of fluid during resuscitation to aid in the promotion of tissue perfusion. Nurses regularly administer IV fluids as part of maintenance infusions or as life-saving therapies and, therefore, need to understand these fluids' impact on their patients. Understanding nurses' existing perceptions of IV fluid management practices are crucial to improving practice.

Methods:

This study used an online survey to gather information on nursing perceptions of IV fluids. Four hundred and sixty-two Canadian nurses from diverse backgrounds were surveyed, including registered nurses, licensed practical nurses and student nurses.

Results:

The study found that the majority of participants agreed that IV fluids, including type, amount, and rationale for infusion, were important. They also agreed that fluids could impact patient outcomes. However, the study found that, despite recognizing the value and importance of fluid management, many nurses struggled with recognizing how to determine a patient's fluid status versus fluid responsiveness.

Conclusion:

This study supports improving nursing education to understand better the differences between fluid volume status and volume responsiveness. Our study also provides evidence that nurses need access to more sophisticated tools to conduct dynamic assessments and better meet patients' needs.

Intravenous (IV) fluids, especially crystalloids, are routinely used in hospitalized patients throughout the patients' stay. Intravenous fluids are a regular daily occurrence, so their importance is often overlooked. Many patients receive large volumes of fluid during resuscitation to aid in promoting tissue perfusion and regulating hemodynamics (Marik et al, 2017). Intravenous fluids are used also as maintenance or replacement fluids and as carriers of medications or nutrition (Malbrain et al, 2018; Silversides et al, 2020). Several studies have attempted to determine the optimal amount and type of fluid for patients, as well as the best time to infuse these fluids (Bartels et al, 2013; Marik, 2016; Vincent, 2019; Casey et al, 2020; Hammond et al, 2020). As nurses regularly administer IV fluids, either as part of maintenance infusions or as lifesaving therapies, they need to understand thoroughly how IV fluids impact their patients (Casey et al, 2020; Marik, 2016). Increasing amounts of new research demonstrate a direct link between IV fluid resuscitation, persistent hypervolemia, and patient outcomes and, therefore, the need to improve intravenous fluid stewardship (Monnet et al, 2016). To improve upon IV fluid management practices first it is necessary to gain a better understanding of nurses' existing perceptions regarding those practices, which is the primary aim of this study. The secondary purpose is to identify potential gaps in knowledge about IV fluid management practices.

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IV fluid

Stewardship

Acute care

Nursing