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Nurses' Indications for Administration of Perioperative Intravenous Fluid Therapy-A Prospective, Descriptive, Single-Center Cohort Study

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@article{d04d73fb8ce247f59a243f68ac6cd894,
title = "Nurses' Indications for Administration of Perioperative Intravenous Fluid Therapy-A Prospective, Descriptive, Single-Center Cohort Study",
abstract = "PURPOSE: To examine whether nurse anesthetists and postanesthesia nurses' administration of intravenous (IV) fluid therapy during surgery and in the postanesthesia care unit is based on evidence. Secondarily to investigate if providing indications for IV fluid administration changed nursing practice.DESIGN: Prospective, descriptive, single-center study in Scandinavia comparing two cohorts.METHODS: Descriptive, fluid volume, and type data were obtained in both cohorts. Cohort 1 (n = 126) was used as baseline data. In cohort 2 (n = 130), nurses recorded indications for type and volume of fluid therapy using a validated list. Analysis compared median volumes of crystalloid or colloid fluids of surgical types by cohort. Analysis compared frequency of given indication reasons for each IV fluid by surgical type.FINDINGS: Basic static variables were chosen most frequently for indications of IV fluid needed for all surgeries except high-risk abdominal surgery where dynamic variables were more frequent. Signs and symptoms of inadequate tissue perfusion were only sparsely indicated. The volume of intraoperative crystalloid fluids was statistically different for patients with hip fracture surgery in cohort 2. Volumes of both colloid and crystalloid fluids were significantly higher for high-risk abdominal surgery in cohort 2.CONCLUSIONS: Nurse anesthetists and nurses in the postanesthesia care unit rely more on basic static parameters than signs of inadequate tissue perfusion when they make decisions about fluid administration. The indications cited for fluid administered to high-risk abdominal surgery and hip fracture patients did not always fit guidelines. This indicates the need of a stronger intervention to change practice to follow evidence-based clinical guidelines.",
keywords = "clinical guidelines, evidence-based nursing, intravenous fluid administration, nurse anesthetists, perianesthesia, perioperative nursing",
author = "Mette Baumgarten and Anne Br{\o}dsgaard and Gitte Bunkenborg and Vibeke N{\o}rholm and Foss, {Nicolai Bang}",
note = "Copyright {\circledC} 2018 The Authors. Published by Elsevier Inc. All rights reserved.",
year = "2019",
month = "8",
doi = "10.1016/j.jopan.2018.12.004",
language = "English",
volume = "34",
pages = "717--728",
journal = "Journal of Perianesthesia Nursing",
issn = "1089-9472",
publisher = "W.B./Saunders Co",
number = "4",

}

RIS

TY - JOUR

T1 - Nurses' Indications for Administration of Perioperative Intravenous Fluid Therapy-A Prospective, Descriptive, Single-Center Cohort Study

AU - Baumgarten, Mette

AU - Brødsgaard, Anne

AU - Bunkenborg, Gitte

AU - Nørholm, Vibeke

AU - Foss, Nicolai Bang

N1 - Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

PY - 2019/8

Y1 - 2019/8

N2 - PURPOSE: To examine whether nurse anesthetists and postanesthesia nurses' administration of intravenous (IV) fluid therapy during surgery and in the postanesthesia care unit is based on evidence. Secondarily to investigate if providing indications for IV fluid administration changed nursing practice.DESIGN: Prospective, descriptive, single-center study in Scandinavia comparing two cohorts.METHODS: Descriptive, fluid volume, and type data were obtained in both cohorts. Cohort 1 (n = 126) was used as baseline data. In cohort 2 (n = 130), nurses recorded indications for type and volume of fluid therapy using a validated list. Analysis compared median volumes of crystalloid or colloid fluids of surgical types by cohort. Analysis compared frequency of given indication reasons for each IV fluid by surgical type.FINDINGS: Basic static variables were chosen most frequently for indications of IV fluid needed for all surgeries except high-risk abdominal surgery where dynamic variables were more frequent. Signs and symptoms of inadequate tissue perfusion were only sparsely indicated. The volume of intraoperative crystalloid fluids was statistically different for patients with hip fracture surgery in cohort 2. Volumes of both colloid and crystalloid fluids were significantly higher for high-risk abdominal surgery in cohort 2.CONCLUSIONS: Nurse anesthetists and nurses in the postanesthesia care unit rely more on basic static parameters than signs of inadequate tissue perfusion when they make decisions about fluid administration. The indications cited for fluid administered to high-risk abdominal surgery and hip fracture patients did not always fit guidelines. This indicates the need of a stronger intervention to change practice to follow evidence-based clinical guidelines.

AB - PURPOSE: To examine whether nurse anesthetists and postanesthesia nurses' administration of intravenous (IV) fluid therapy during surgery and in the postanesthesia care unit is based on evidence. Secondarily to investigate if providing indications for IV fluid administration changed nursing practice.DESIGN: Prospective, descriptive, single-center study in Scandinavia comparing two cohorts.METHODS: Descriptive, fluid volume, and type data were obtained in both cohorts. Cohort 1 (n = 126) was used as baseline data. In cohort 2 (n = 130), nurses recorded indications for type and volume of fluid therapy using a validated list. Analysis compared median volumes of crystalloid or colloid fluids of surgical types by cohort. Analysis compared frequency of given indication reasons for each IV fluid by surgical type.FINDINGS: Basic static variables were chosen most frequently for indications of IV fluid needed for all surgeries except high-risk abdominal surgery where dynamic variables were more frequent. Signs and symptoms of inadequate tissue perfusion were only sparsely indicated. The volume of intraoperative crystalloid fluids was statistically different for patients with hip fracture surgery in cohort 2. Volumes of both colloid and crystalloid fluids were significantly higher for high-risk abdominal surgery in cohort 2.CONCLUSIONS: Nurse anesthetists and nurses in the postanesthesia care unit rely more on basic static parameters than signs of inadequate tissue perfusion when they make decisions about fluid administration. The indications cited for fluid administered to high-risk abdominal surgery and hip fracture patients did not always fit guidelines. This indicates the need of a stronger intervention to change practice to follow evidence-based clinical guidelines.

KW - clinical guidelines

KW - evidence-based nursing

KW - intravenous fluid administration

KW - nurse anesthetists

KW - perianesthesia

KW - perioperative nursing

UR - http://www.scopus.com/inward/record.url?scp=85062099614&partnerID=8YFLogxK

U2 - 10.1016/j.jopan.2018.12.004

DO - 10.1016/j.jopan.2018.12.004

M3 - Journal article

VL - 34

SP - 717

EP - 728

JO - Journal of Perianesthesia Nursing

JF - Journal of Perianesthesia Nursing

SN - 1089-9472

IS - 4

ER -

ID: 57355970