Rational and irrational use of intra-venous infusions: a cross-sectional study among patients of a tertiary care hospital
DOI:
https://doi.org/10.18203/2349-3933.ijam20193287Keywords:
Awareness, Doctors, Intravenous infusions, RationalAbstract
Background: Intravenous infusions (IV) are a rapid mean of administering drugs. Hospitals are commonplace for their use, but at the same time they have many serious potential complications. This study aims to know the justified use of intravenous infusion among patients of a tertiary care hospital and awareness about its use.
Methods: It was a cross-sectional study in which 249 subjects were conveniently studied. Nil per oral, severity of dehydration, vomiting, and diarrhoea was used as confirmatory criteria for using IV Infusions. Questionnaire with verbal consent was used to collect the data. Descriptive statistical analysis was applied to analyse the data and presented as means, frequencies and percentages in the form of tables and figure.
Results: Total n249 (100%) subjects, n68 (27.3%) males and n181 (72.7%) females with average age was 24.05±14.21 years participated. Among n116 (46.6%) irrational users, females n76 (30.5%) were more then males n40 (16.1) with significant difference, p= 0.018. However, no significant difference was found among other variables (age groups, profession, education, awareness and rational or irrational use of IV infusion). Majority n249, n204 (81.9%) were not aware of the IV infusion medication error and doctors were most common unjustified prescribers of IV infusion, n105 (90.5%).
Conclusions: The study concluded with the more prevalent irrational IV infusion use in our setup. Doctors appeared the dominant prescriber of irrational IV infusion. This statement is astonishing and must not be overlooked. Female gender, adult age, under-grade patients and students are more exposed to irrational IV infusion.
References
Ding Q, Barker KN, Flynn EA, Westrick SC, Chang M, Thomas RE, et al, Incidence of Intravenous Medication Errors in a Chinese Hospital. Value Health Reg Issues. 2015;6:33-9.
World Health Organization. The pursuit of responsible use of medicines: sharing and learning from country experiences. WHO/EMP/MAR/2012/3/. [internet] Geneva: World Health Organisation; 2012 oct. [cited: 23 July 2019]. Available at: http://www.mentalhealthcommission.gov.au/media/39273/NMHC_ReportCard_Lo-res.pdf.
Ahmad MP. Medication Errors. HPJ Pharmacy Bull. 2014;2/2014:12-14.
Padhi S, Bullock I, Li L, Stroud M. Intravenous fluid therapy for adults in hospital: summary of NICE guidance. BMJ. 2013;347:f7073.
Cassano-Piché A, Fan M, Sabovitch S, Masino C, Easty AC. Multiple intravenous infusions phase 1b: practice and training scan. Ontario Heal Techn Assessment Series. 2012;12(16):1-132.
Hoste EA, Maitland K, Brudney CS, Mehta R, Vincent J-L, Yates D et al. Four phases of intravenous fluid therapy: a conceptual model. British J Anaesthesia; 2014;113(5):740-7.
Keers RN, Williams SD, Cooke J, Ashcroft DM. Prevalence and nature of medication administration errors in health care settings: a systematic review of direct observational evidence. Ann Pharmacotherapy. 2013;47(2):237-56.
Schmid MW. Risks and complications of peripherally and centrally inserted intravenous catheters. Crit Care Nursing Clin. 2000;12(2):165-74.
Hospital-acquired infections. Encyclopaedia of Surgery. Available at: https://www.surgeryencyclopedia.com/Fi-La/Hospital-Acquired-Infections.html. Accessed 1 May 2019.
Naidu K, Nabose I, Ram S, Viney K, Graham SM, Bissell K. A descriptive study of nosocomial infections in an adult intensive care unit in fiji: 2011-12. J Trop Med. 2014;2014:545160.
Lee W-L, Chen H-L, Tsai T-Y, Lai I-C, Chang W-C, et al, Risk factors for peripheral intravenous catheter infection in hospitalized patients: A prospective study of 3165 patients. Am J Infection Control. 2009;37(8):683-6.
Shamsuddin AF, Shafie SD. Knowledge of nurses in the preparation and administration of intravenous medications. Procedia-Social and Behavioral Sciences. 2012;17(60):602-609.
Macias A, De la Torre A, Huertas-Jimenez MA, Silva Y, González L, Polanco C. Endemic IV fluid contamination in hospitalized children in Mexico. A problem of serious public health consequences. Am J Infection Control. 2012;40(5):e180-1.
Michael J. Berens T. Nursing mistakes kill, injure thousands. Available at: https://webcache.googleusercontent.com/search?q=cache:fDjAVSVYocoJ:https://www.chicagotribune.com/news/ct-xpm-2000-09-10-0009100243-story.html+&cd=1&hl=en&ct=clnk&gl=pk. Accessed 1 May 2019.
Curtis R. Catheter-Related Bloodstream Infection in the Intensive Care Unit. J of the Intensive Care Society. 2009;10(2):102-108.
Haut E, Kalish B, Cotton B, Efron D, Haider A, Stevens K, et al. Prehospital intravenous fluid administration is associated with higher mortality in trauma patients. Ann Surg. 2011;253(2):371-7.
Gediwon N, Kebede Y, Hawaze S. Medication errors in the adult emergency unit of a tertiary care teaching hospital in Addis Ababa. Arch Pharmacy Prac. 2013;4(4):147-153.
Fekadu T, Teweldemedhin M, Esrael E, Asgedom SW. Prevalence of intravenous medication administration errors: a cross-sectional study. Integrated Pharmacy Res Prac. 2017;6:47.
Ismail S, Taqi A. Medical errors related to look-alike and sound-alike drugs. Anaesth Pain Intensive Care. 2013;17(2):117-122.
Al-Jarrah BH, Al-Nema ZM. Indications of IV Fluids in Medical City. Iraqi Postgraduate Med J. 2009;8(4):380-3.
Waitt C, Waitt P, Pirmohamed M. Intravenous therapy. Postgrad Med J. 2004;80:1-6.
World health organization. World alliance for patient safety. Global patient safety challenge. [internet]. Geneva, 2005-2006. Available at. https://www.who.int/patientsafety/events/05/GPSC_Launch_ENGLISH_FINAL.pdf. [Cited: 23 July 2019].
