Original Article

Evaluation of Parenteral Electrolyte Solution Utilization and Fluid Therapy in Surgical Department of Imam Reza, Mashhad, Iran

Abstract

Background: Intravenous fluid therapy is frequently used for hospitalized patients but it is overused in many cases. This can lead to economic burden in addition to complications. Few studies have investigated fluid therapy cost-related errors. Drug Use Evaluation (DUE) can be used to evaluate these errors. The aim of our research is to evaluate fluid therapy errors in surgery ward of Imam Reza Hospital, Mashhad, Iran.
Methods: During this cross-sectional study, patients selected by simple randomization method from surgical ward of a teaching hospital in Mashhad, Iran. Intravenous fluid therapy information including indication, type, volume and rate of fluid administration was recorded for each patient. An internal protocol for intravenous fluid therapy was designed based on literature review and available recommendations by clinical pharmacists. The data related to patients’ fluid therapy were compared with this protocol. Main outcome measure of this study was any mistake in the selection of fluid type, content, volume and rate of administration.
Results: One hundred patients were observed during study. Errors in the rate of fluid administration (85%), incorrect fluid volume calculation (83%) and incorrect type of fluid selection (1%) were the most common types of errors.
Conclusion: Our result showed that intravenous fluid therapy errors occurred commonly in the hospitalized patients especially in the medical wards. Improvement in knowledge and attention of health-care workers about these errors are essential for preventing of medication errors in aspect of fluid therapy.

1. Rooker JC, Gorard DA. Errors of intravenous fluid infusion rates in medical inpatients. Clin Med 2007;7(5):482-5.
2. Mousavi M, Khalili H, Dashti-Khavidaki S. Errors in fluid therapy in medical wards. Int J Clin Pharm 2012;34(2):374-81.
3. Han PY, Coombes ID, Green B. Factors predictive of intravenous fluid administration errors in Australian surgical care wards. Qual Saf Health Care 2005;14(3):179-84.
4. Samilski JA, Lau TT, Elbe DH, Aulakh AK, Lun EM. Drug use evaluation of moxifloxacin (avelox) using a hand-held electronic device at a canadian teaching hospital. P T 2012;37(5):291.
5. Chiatti C, Bustacchini S, Furneri G, et al. The economic burden of inappropriate drug prescribing, lack of adherence and compliance, adverse drug events in older people: a systematic review. Drug Saf 2012;35( Suppl 1):73-87.
6. Choi I, Lee SM, Flynn L, et al. Incidence and treatment costs attributable to medication errors in hospitalized patients. Res Social Adm Pharm.2016;12(3):428-37.
7. Varadhan KK, Lobo DN. A meta-analysis of randomised controlled trials of intravenous fluid therapy in major elective open abdominal surgery: getting the balance right. Proc Nutr Soc 2010;69(4):488-98.
8. Koda-Kimble MA, Young LY 2012 Applied Therapeutics: The Clinical Use of Drugs Baltimore, Lippincott Williams & Wilkins 1461–1467.
9. Siparsky N. Overview of postoperative fluid therapy in adults. Collins KA, ed. UpToDate. Waltham, MA: UpToDate Inc. https://www.uptodate.com (Accessed on January 02, 2015.)
10. Westbrook JI, Rob MI, Woods A, Parry D. Errors in the administration of intravenous medications in hospital and the role of correct procedures and nurse experience. BMJ Qual Saf 2011;20(12):1027-34.
11. Mansouri A, Ahmadvand A, Hadjibabaie M, Kargar M, Javadi M, Gholami K. Types and severity of medication errors in Iran; a review of the current literature. Daru 2013;21(1):49.
12. Leendertse AJ, Van Den Bemt PM, Poolman JB, Stoker LJ, Egberts AC, Postma MJ. Preventable hospital admissions related to medication (HARM): cost analysis of the HARM study. Value Health 2011;14(1):34- 40.
13. Lyu PF, Murphy DJ. Economics of fluid therapy in critically ill patients. Curr Opin Crit Care 2014;20(4):402-7.
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IssueVol 6, No 3-4 (Summer 2018) QRcode
SectionOriginal Article(s)
Keywords
medication errors surgical ward Drug Use Evaluation Fluid Therapy
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Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Momken M, Mohammadpour AH, Elahifard H, Haddadi Avva A, Rohani B, Rezaei F, Nazemian F, Elyasi S. Evaluation of Parenteral Electrolyte Solution Utilization and Fluid Therapy in Surgical Department of Imam Reza, Mashhad, Iran. J Pharm Care. 2019;6(3-4):58-61.