214 Chapter 7 There is a risk of selection bias, the participants might be those most interested in intravenous fluid therapy, potentially underrepresenting those who do not view this as an important aspect of their practice. We attempted to mitigate this underrepresentation by recruiting through nursing students on their own wards and ensuring anonymous participation. However, due to our pragmatic and varied recruitment methods, we could not determine the exact response rate. Second, our study did not account for exceptions where continuous intravenous fluids are indicated. For instance, we did not consider the frequency of intravenous medication administration. At a high frequency it might be the best option to use a keep-the-vein-open rate to limit connecting and disconnecting the intravenous lines to reduce infection risk. After every disconnection the intravenous fluid line should be discarded to prevent contamination [41], which is not sustainable or practical with frequent intermitting medication admissions [42, 43]. Conclusions Our study revealed a clear knowledge gap among healthcare professionals regarding intravenous fluid therapy concerning the composition of frequently used intravenous fluids. As well as limited documentation of the indication, and frequent use of keep-the-vein-open rates. Although most patients receive intravenous fluids during hospitalization, it is highly likely that not all patients actually require intravenous fluids. The knowledge gap, coupled with the paucity of documentation regarding the indication for the intravenous fluids, reflects a blind spot among healthcare providers about the importance of sufficient knowledge and awareness of the risks associated with intravenous fluid therapy. It seems there is no conscious handling of this type of medicine. The perceived shared responsibility constitutes an entry point to develop a collaborative protocol to guide nurses and prescribers to more targeted intravenous fluid therapy.
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