204 Chapter 7 Most of the prescribers (n=20/25; 80%) expect that nurses independently start, stop or change intravenous fluid therapy, commenting that they trust the nurses’ expertise in most cases, but expect to be consulted in more complex situations. Prescriber 465: “In most cases, I believe ward nurses can make a good assessment of whether there is sufficient intake and when the infusion can be phased-out and/or discontinued. I think nurses can make a good assessment when to start infusion if there is a lot of fluid loss and little intake. Adjusting the infusion, especially major adjustments, is often preferable in consultation, given some patients' histories or disease progression and in order to maintain a little more control and overview” Prescriber 399: “The nurses on the ward have a lot of experience with infusion therapy and know how to handle it well, when in doubt they consult with the physician on duty” Knowledge of Nurses and Prescribers concerning Intravenous Fluid Therapy Overall, the median number of correct answers was eight out of twelve questions (IQR 7-9, range 0-12). Four participants (1.3%), all with a nursing background, answered all knowledge questions correctly;. One of the participants, a nurse, answered none of the questions correctly. Most participants answered the questions about indications, contraindications, complications, and symptoms of decompensation of intravenous fluid therapy correctly. There were no significant differences between nurses and prescribers for most questions, expect for the question on the indications of intravenous fluids (p=0.042). There was only one participating ward from the general hospital, making statistical comparisons with the teaching hospitals or the university hospital unjustifiable (respectively 14, 178 and 87 nurses, and respectively 2, 14 and 9 prescribers). Overall, the median number of correctly answered questions at the general hospital was lower for the nurses and higher for the prescribers. In contrast, there was no difference in median scores (8 correct answers) between nurses and prescribers in the teaching and university hospital. Table 2 presents the results of the knowledge questions per participant group. Twenty percent (n=55) of the nurses, and 12% (n=3) of the prescribers indicated compliance with the current fasting guideline in case of postponed surgery. More than half of participants (59% n=165/279 nurses; 56% n=14/25 prescribers) preferred to increase the infusion rate (see question 12). Question 9, which assessed knowledge of the
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