203 Inns and outs of intravenous fluids 7 Table 1 Nurses and prescribers demographics Nurses (%) Prescribers (%) All participants (%) Participants 279 (91.7) 25 (8.2) 304 (100) Nursing students 36 (12.9) - 36 (11.8) BIAZ^ 40 (14.3) 1 (4.0) 41 (13.5) Years of work experience† 3 [2-8] 3 [1-5] 3 [2-8] Age† 27 [23-37] 33.0 [27.5 – 40.5] 28 [23-37.5] Hospital Teaching hospital 178 (63.8) 14 (56.0) 192 (63.2) University hospital 87 (31.2) 9 (36.0) 96 (31.6) General hospital 14 (5.0) 2 (8.0) 16 (5.2) Ward Surgical 124 (44.4) 7 (28.0) 131 (43.1) Non-surgical 84 (30.1) 12 (48.0) 96 (31.6) Mixed 71 (25.4) 6 (24.0) 77 (25.3) ^BIAZ = Basic intensive acute care certificate. Additional training for nurses to recognize abnormalities in vital signs, electrolyte disturbances, and how to effectively intervene. † Median, [IQR] Nurses’ Self-reported practices and Prescribers’ Expectations Nurses reported that they stop (n=206/279; 74%) or start (n=192/279; 69%) the intravenous fluid therapy, or change the rate (n=192/279; 69%) on their own initiative. Almost thirty percent (n=82/279; 29%) stated that they change the type of fluid without consulting a physician. The majority of the nurses (n=216/279; 77%) elaborated on reasons to start, stop or change the intravenous fluid therapy. Among those, 29 (13.4%) nurses emphasized that they discussed their actions with the prescriber immediately after changing the infusion rate or type of fluid. A postoperative switch from Ringers Lactate to sodium chloride 0.9% solution was commonly mentioned. Nurse 185: "If a patient suddenly has a fever, or suddenly has to start fasting, and the doctor has not yet assessed the patient, and the patient needs more infusion for those reasons. Also, if I suspect that a patient is decompensated and I have called the doctor about this and I am still waiting for the doctor's assessment, I often temporarily lower the infusion” Nurse 347: “When the patient drinks sufficiently I lower the infusion” Nurse 93: “Guided by patient intake, patient history”
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