Quality standard

Quality statement 5: Intravenous (IV) fluids lead

Quality statement

Hospitals have an intravenous (IV) fluids lead who has overall responsibility for training, clinical governance, audit and review of IV fluid prescribing, and patient outcomes.

Rationale

The IV fluids lead in a hospital can promote best practice, ensuring that healthcare professionals are trained in prescribing and administering IV fluid therapy, and reviewing learning from incidents. This leadership role can ensure continuity of care in relation to fluid management through coordination between different hospital departments. Improved learning may reduce the number of future patient safety incidents.

Quality measures

The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured, and can be adapted and used flexibly.

Structure

Evidence that hospitals have an IV fluids lead who has overall responsibility for ensuring adequate training, clinical governance, audit and review of IV fluid prescribing, and patient outcomes.

Data source: Local data collection.

Outcome

Patient safety incidents resulting from errors in IV fluid therapy in term neonates, children and young people.

Data source: Local data collection.

What the quality statement means for different audiences

Service providers (hospitals) ensure that they have an IV fluids lead who has overall responsibility for ensuring adequate training, clinical governance, audit and review of IV fluid prescribing, and patient outcomes.

Healthcare professionals who care for term neonates, children and young people receiving IV fluid therapy in hospital work in the context of clinical governance arrangements that have an IV fluids lead who has overall responsibility for ensuring adequate training, clinical governance, audit and review of IV fluid prescribing, and patient outcomes.

Commissioners ensure that they commission services from hospitals that have an IV fluids lead who has overall responsibility for ensuring adequate training, clinical governance, audit and review of IV fluid prescribing, and patient outcomes.

Term neonates (babies born at full term), children and young people receiving IV fluid therapy are cared for in a hospital that has a person who has overall responsibility for ensuring that they receive safe and effective IV fluid therapy. Intravenous fluids (usually shortened to 'IV' fluids) are liquids given to replace water, sugar and salt that a person might need if they are ill or having an operation, and can't eat or drink as they would normally. IV fluids are given straight into a vein through a drip.

Source guidance

Intravenous fluid therapy in children and young people in hospital. NICE guideline NG29 (2015, updated 2020), recommendation 1.8.1

Definitions of terms used in this quality statement

Responsible IV fluids lead

The IV fluids lead will have overall responsibility, through a leadership role, for the quality of care relating to IV fluid therapy. The IV fluids lead should be somebody in a senior position, and may delegate specific functions through normal governance structures. The IV fluids lead is not expected to be the person who delivers the training, clinical governance, audit and review of IV fluid prescribing, and patient outcomes. Those functions can be delegated to professionals who have the necessary specialist knowledge in the hospital. For hospitals that provide both adult and children's services, this may be a single role with support from healthcare professionals with expertise from both services. [Expert opinion]