200 Chapter 7 ‘nurses’ and ‘prescribers’, respectively. Recruitment methods included posters, emails, and face-to-face invitations, performed by baccalaureate nursing students. The same baccalaureate nursing students collected data from conveniently selected electronic healthcare charts of patients on the corresponding wards. All patients admitted for at least 48 hours were eligible for inclusion. We aimed to include approximately 25 patients per ward. Instruments For the survey study, a literature search yielded a few questionnaires that covered knowledge of intravenous fluid therapy [15, 16, 22]. However, most were either context-specific or the questionnaire was not accessible. Therefore, baccalaureate nursing students under expert supervision of an internist (JA) and a cardiac care nurse (DS) developed a new questionnaire based on their experience and a review of the literature, see supplement 1. The questionnaire opened with a statement to clarify that this questionnaire consisted of questions regarding intravenous fluids without the addition of medication, namely, Glucose 5%, Sodium Chloride 0.9%, Ringer’s solution, Glucose 2.5%/Sodium Chloride 0.45%, Gelofusine, Mannitol, Voluven. The questionnaire consisted of two parts and collected respondents’ background characteristics. Respondents’ characteristics included profession, ward, and years of work experience. Nurses were asked if they had completed a specialized training such as Oncology care or the Basic Intensive Acute Care (BIAZ) course. The BIAZ course trains in recognizing abnormalities in vital signs, electrolyte disturbances, and how to effectively intervene. The first part dealt with self-reported practices in terms of nurses’ initiative in starting, stopping, or changing intravenous fluids and prescribers’ expectations’ regarding nurses taking initiative. The second section concerned knowledge of indications, contra-indications, and complications of intravenous fluid therapy. All knowledge questions were multiple-choice, with at least three answer options. This questionnaire was piloted by baccalaureate nursing students and due to multiple correct answers or interpretability issues subsequently slightly adjusted with the research-group (JA, DS, MD, EI). Eventually, twelve knowledge questions were selected. Data for the chart review were collected with a predefined checklist, structured to match the sections in the electronic patient records, see figure 1. The data was collected for the previous 24 hours of admission, and included reason for admission, preconditions, age, and sex, along with documentation of administered intravenous fluids. In case of intravenous fluid administration the administered fluid type (e.g., sodium chloride 0.9%,
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