Date of Award
DNP Doctor of Nursing Practice
Mary Ellen Roberts, DNP
Eileen Toughill, Ph.D
Maureen Schneider, Ph.D
Purpose: The purpose of this quality initiative is to bridge the gap between evidence and practice related to the management of intravenous (IV) fluids in the hospital setting and to increase awareness regarding important quality issues, highlighting the critical role of nurses in effecting change in the health delivery system.
Significance of Project: The administration of IV fluids is one of the most common interventions in the hospital setting. The associated complication rate is higher than previously believed. Adverse effects impact recovery time, length of stay, cost, patient safety and survival. Related complications are largely preventable and unmet educational needs are well documented. An increase in evidence based management has the potential to improve patient outcomes that affect a number of quality indicators.
Methods: The project was implemented at a mid-size community medical center. An educational initiative developed for bedside nurses was coupled with system level interventions to minimize risk. The content included recommendations from clinical practice guidelines and data from several studies supporting a shift to more conservative fluid management strategies. The sessions emphasized assessment skills and critical thinking to enhance therapeutic effectiveness and prevent complications.
Project Outcomes: The project was well received by nursing staff and leadership. The anticipated effect will be a reduction in the overutilization of IV fluids, resulting in a lower complication rate. An exit survey indicated that the information provided would influence nursing practice at the bedside and the content was subsequently adapted for integration into the hospital’s RN orientation program. A prompt in the electronic health record (EHR) to reevaluate the need for IV fluids every 24 hours will be implemented when the facility completes their transition to an updated EHR system.
Clinical Relevance: The assimilation of evidence into practice is an essential component of delivering higher quality healthcare. Nurses have a professional obligation to protect patients from harm and exposure to avoidable risk. Appropriate clinical management of IV fluids and early recognition of complications can prevent adverse events that negatively impact a range of patient outcomes.
Connolly, Katherine, "A Quality Improvement Initiative Aimed at Reducing Complications Related to IV Fluid Administration in the Acute Care Setting" (2016). Seton Hall University DNP Final Projects. 15.