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DODD and SMITH
FIGURE 7 Based on 50 mL/kg/day, weight (kg) is recorded against fluid volume per hour (L/h). Each coloured line represents a fluid rate. When the fluid rate is known, the user can determine the volume of fluid needed per hour for the weight of the horse.
period. This may be due to the duties involved during this period, such as treatment administration, which may have impacted the monitoring of the fluids. A pertinent finding in this audit is the improvement of the
standard of care. After the initial presentation of results in 2020, improvements were discussed verbally and through handwritten guides between all teams and an initial plan was created. Raising awareness of the issues presented and communication between all teams in the improvement process created motivation to im- prove the current situation. The re- audit found that the record- ing of data had significantly improved, patients received closer to the recommended amount of fluid and overall staff deemed themselves more confident and competent. A clinical audit is a continuous process designed to highlight shortfalls and encour- age development to ensure the highest quality of care is given. This data shows there are still improvements that can be made for the second re- audit.
Main limitations
• This audit was undertaken only in January– June, a larger sample size would yield more accurate results.
• Unrecorded results do not imply that no action was taken. • Cannot represent all patients as some records were unable to be analysed.
• Calculation of night- and day- time periods, for example some horses were on fluids for an hour during the night and this counted as a night period for this horse.
Recommendations
• Weigh each horse before starting IVFT and plot the LOBF based on an accurate weight.
• Standardise a fluid ‘check’ as part of a clinical check on the patient. • Calculate the fluid graph based on weight. Produce a table to eliminate the need for calculation each time (Figure 7 ). • (Weight [kg] × maintenance rate/24)/1000. • The weight × maintenance rate (50 mL/kg/day) is divided by 24 to get the litres per day. This number is divided by 1000 to get the litres per hour.
• For this hospital, the handover between the day and the night period was when the fluids were slower. An improved method of handover between staff could be discussed (e.g. record fluids during the handover).
AUTHOR CONTRIBUTIONS N. A. Dodd and M. R. W. Smith contributed to the study design and execution. Data analysis, statistics and most interpretations were conducted by N. A. Dodd. The manuscript was mostly conducted
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