dc.contributor.author | Kenyatta, Gloria K | |
dc.date.accessioned | 2013-05-23T09:16:10Z | |
dc.date.available | 2013-05-23T09:16:10Z | |
dc.date.issued | 2010 | |
dc.identifier.citation | Master of Pharmacy in Clinical Pharmacy | en |
dc.identifier.uri | http://erepository.uonbi.ac.ke:8080/xmlui/handle/11295/24752 | |
dc.description.abstract | Background
Iatrogenic problems arising from inappropriate IV fluid therapy can increase morbidity and
prolong hospital stay. Among those at risk, are the elderly patients as they have a high burden
of cardio respiratory and renal diseases. Volumes and types of IV fluids will vary depending
on the clinical scenario. Therefore, monitoring of fluid balance parameters is crucial and
should remain consistent regardless of the clinical indications for IV fluids. Research has
revealed gaps in the monitoring of fluid balance among the elderly patients.
Objective
The study thus aimed to establish if IV fluids were prescribed rationally and to determine if
fluid balance was adequately monitored in elderly patients.
Methodology
This was a longitudinal descriptive study. All elderly patients who met the inclusion criteria,
between March and July 2010 in Kenyatta National Hospital, were followed up until the day
of discharge or death. A universal sample of 150 patients was obtained. The data obtained
were entered into a structured data collection form. The data were analyzed using SPSS 12.0
software. Descriptive data analysis was performed on all variables. Exploratory data analysis
was done to assess variables for associations and correlations. Multivariate logistic regression
was done to control for confounding.
Results
A good majority of the patients (87.3 %) had IV fluids rationally prescribed. About 79.3 %
had their baseline UEC determined. The most commonly prescribed IV fluid was Normal
saline. The IV fluid most prone to administration errors was Normal saline alternating with 5
% dextrose. About 25 % of the patients either had no prescriptions for IV fluids or had
incomplete prescriptions, though they received IV fluids. Weight and fluid charting were the
least frequently monitored parameters. In contrast, vital signs and clinical signs and
symptoms were the most frequently monitored (98 %). Determination of baseline UEC,
duration of hospital stay and duration of IV fluid administration were found to be
significantly associated with adequate monitoring. (P<0.05)
x
Conclusion and recommendations
The study found that only 50% of the patients were noted to have had their fluid balance
parameters adequately monitored. Lack of clarity of some of the prescriptions may have
contributed to errors observed. Redesigning of the IV fluid prescription segment of the
treatment sheet will go a long way in ensuring clarity ofthe prescription. Continuous Medical
Education should be encouraged so as to stress the need to give IV fluid prescriptions just as
much importance as is given to other medication.
Xl | en |
dc.language.iso | en | en |
dc.publisher | University Of Nairobi | en |
dc.title | Adequacy of monitoring of intravenous Fluids in elderly patients in Kenyatta National hospital | en |
dc.type | Thesis | en |
dc.description.department | a
Department of Psychiatry, University of Nairobi, ; bDepartment of Mental Health, School of Medicine,
Moi University, Eldoret, Kenya | |
local.publisher | College of Health Sciences | en |