Received: 30 November 2022 | Accepted: 14 April 2023 DOI: 10.1111/eve.13817
OR IG INA L A R T I C L E
A clinical audit of the intravenous fluid therapy given to hospitalised horses
Natalie A. Dodd | Matthew R. W. Smith
Newmarket Equine Hospital , Newmarket , UK
Correspondence : Natalie A. Dodd Email:
nat.dodd4@
gmail.com
Present address Natalie A. Dodd, Catley Cross Veterinary Clinic , Halstead , UK
Funding information No funding was received for this research.
Summary Background : This audit was conducted as it was noted that intravenous fluid therapy (IVFT) was not as precise as anticipated. The aim was to enhance the precision of IVFT given to patients. Objectives : To (1) quantify the discrepancies in intravenous fluid administered to patients compared to prescribed volumes; (2) investigate causative factors, and develop an action plan to improve care quality and (3) assess the effectiveness of implemented changes. Study design : A clinical audit was conducted. Clinical notes from horses receiving IVFT from January to June 2020 were analysed. Methods of improvement were discussed and implemented and a re- audit was then conducted from January to June 2021. Methods : A 24- h period was divided into a day- time period from 08:00 AM to 18:00 PM and a night period from 18:00 PM to 08:00 AM and the prescribed fluid volume was compared to the actual volume administered to ICU patients during these periods. For the re- audit, modifications were made, including the use of a modified analogue scale to quantify the remaining fluid volume in the bags, and revised recording sheets for inten- sive care and fluid therapy. Results : In 2020, 19/73 horses had records eligible for analysis. Horses received within 5 L of the prescribed volume in 14/53 (26%) time periods recorded. In 2021, 88/105 horses were eligible for data analysis. Horses received within 5 L of the prescribed vol- ume in 156/220 (71%) time periods recorded. The Mann– Whitney U test was used to compare the difference in fluid volume prescribed and received between 2020 and 2021. The obtained p value of 0.0001295 revealed a significant difference between the 2 years, suggesting that the observed variation in fluid volume was not by chance. Conclusions : The clinical audit facilitated demonstrable improvement and enhanced the standard of care.
K E YWORDS horse , audit , colic , fluid therapy , intravenous
INTRODUCTION
A clinical audit is defined as a quality improvement process that seeks to improve patient care by systematically reviewing aspects of current practice against a definable standard using evidence- based medicine. It highlights discrepancies and allows for the
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implementation of improvements. Changes and further monitor- ing are then implemented at an individual or team level to allow for continuous
improvement in patient care (Esposito & Dal
Canton, 2014 ). The reasons to undertake a clinical audit are to check clinical care meets the defined quality standards, this will improve patient care,
aaep.org/wiley-redirect Equine Vet Educ. 2024;36:26–35.
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