Are Further Interventions Needed to Prevent and Manage Hospital-Acquired Hyponatraemia? A Nationwide Cross-Sectional Survey of IV Fluid Prescribing Practices
Background: Hyponatraemia is associated with increased morbidity, increased mortality and is frequently hospital-acquired due to inappropriate administration of hypotonic fluids. Despite several attempts to minimise the risk, knowledge is lacking as to whether inappropriate prescribing practice cont...
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| Format: | Article |
| Language: | English |
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MDPI AG
2020-08-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/9/9/2790 |
| _version_ | 1797555176786100224 |
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| author | Per Sindahl Christian Overgaard-Steensen Helle Wallach-Kildemoes Marie Louise De Bruin Hubert GM Leufkens Kaare Kemp Helga Gardarsdottir |
| author_facet | Per Sindahl Christian Overgaard-Steensen Helle Wallach-Kildemoes Marie Louise De Bruin Hubert GM Leufkens Kaare Kemp Helga Gardarsdottir |
| author_sort | Per Sindahl |
| collection | DOAJ |
| description | Background: Hyponatraemia is associated with increased morbidity, increased mortality and is frequently hospital-acquired due to inappropriate administration of hypotonic fluids. Despite several attempts to minimise the risk, knowledge is lacking as to whether inappropriate prescribing practice continues to be a concern. Methods: A cross-sectional survey was performed in Danish emergency department physicians in spring 2019. Prescribing practices were assessed by means of four clinical scenarios commonly encountered in the emergency department. Thirteen multiple-choice questions were used to measure knowledge. Results: 201 physicians responded corresponding to 55.4% of the total population of physicians working at emergency departments in Denmark. About a quarter reported that they would use hypotonic fluids in patients with increased intracranial pressure and 29.4% would use hypotonic maintenance fluids in children, both of which are against guideline recommendations. Also, 29.4% selected the correct fluid, a 3% hypertonic saline solution, for a patient with hyponatraemia and severe neurological symptoms, which is a medical emergency. Most physicians were unaware of the impact of hypotonic fluids on plasma sodium in acutely ill patients. Conclusion: Inappropriate prescribing practices and limited knowledge of a large number of physicians calls for further interventions to minimise the risk of hospital-acquired hyponatraemia. |
| first_indexed | 2024-03-10T16:42:46Z |
| format | Article |
| id | doaj.art-45c4d596ec89458d8b0c59435adaaa2a |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T16:42:46Z |
| publishDate | 2020-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-45c4d596ec89458d8b0c59435adaaa2a2023-11-20T11:49:53ZengMDPI AGJournal of Clinical Medicine2077-03832020-08-0199279010.3390/jcm9092790Are Further Interventions Needed to Prevent and Manage Hospital-Acquired Hyponatraemia? A Nationwide Cross-Sectional Survey of IV Fluid Prescribing PracticesPer Sindahl0Christian Overgaard-Steensen1Helle Wallach-Kildemoes2Marie Louise De Bruin3Hubert GM Leufkens4Kaare Kemp5Helga Gardarsdottir6Danish Medicines Agency, Division of Pharmacovigilance and Medical Devices, 2300 Copenhagen, DenmarkDepartment of Intensive Care 4131, Rigshospitalet, 2100 Copenhagen, DenmarkSection for Social and Clinical Pharmacy, Department of Pharmacy, Faculty of Health and Medical Sciences, University of Copenhagen, 2100 Copenhagen, DenmarkCopenhagen Centre for Regulatory Science, Department of Pharmacy, Faculty of Health and Medical Sciences, University of Copenhagen, 2100 Copenhagen, DenmarkDivision of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, 3584CG Utrecht, The NetherlandsDanish Medicines Agency, Division of Pharmacovigilance and Medical Devices, 2300 Copenhagen, DenmarkDivision of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, 3584CG Utrecht, The NetherlandsBackground: Hyponatraemia is associated with increased morbidity, increased mortality and is frequently hospital-acquired due to inappropriate administration of hypotonic fluids. Despite several attempts to minimise the risk, knowledge is lacking as to whether inappropriate prescribing practice continues to be a concern. Methods: A cross-sectional survey was performed in Danish emergency department physicians in spring 2019. Prescribing practices were assessed by means of four clinical scenarios commonly encountered in the emergency department. Thirteen multiple-choice questions were used to measure knowledge. Results: 201 physicians responded corresponding to 55.4% of the total population of physicians working at emergency departments in Denmark. About a quarter reported that they would use hypotonic fluids in patients with increased intracranial pressure and 29.4% would use hypotonic maintenance fluids in children, both of which are against guideline recommendations. Also, 29.4% selected the correct fluid, a 3% hypertonic saline solution, for a patient with hyponatraemia and severe neurological symptoms, which is a medical emergency. Most physicians were unaware of the impact of hypotonic fluids on plasma sodium in acutely ill patients. Conclusion: Inappropriate prescribing practices and limited knowledge of a large number of physicians calls for further interventions to minimise the risk of hospital-acquired hyponatraemia.https://www.mdpi.com/2077-0383/9/9/2790hyponatraemiafluid therapyintravenous fluidsprescribing practiceknowledge |
| spellingShingle | Per Sindahl Christian Overgaard-Steensen Helle Wallach-Kildemoes Marie Louise De Bruin Hubert GM Leufkens Kaare Kemp Helga Gardarsdottir Are Further Interventions Needed to Prevent and Manage Hospital-Acquired Hyponatraemia? A Nationwide Cross-Sectional Survey of IV Fluid Prescribing Practices Journal of Clinical Medicine hyponatraemia fluid therapy intravenous fluids prescribing practice knowledge |
| title | Are Further Interventions Needed to Prevent and Manage Hospital-Acquired Hyponatraemia? A Nationwide Cross-Sectional Survey of IV Fluid Prescribing Practices |
| title_full | Are Further Interventions Needed to Prevent and Manage Hospital-Acquired Hyponatraemia? A Nationwide Cross-Sectional Survey of IV Fluid Prescribing Practices |
| title_fullStr | Are Further Interventions Needed to Prevent and Manage Hospital-Acquired Hyponatraemia? A Nationwide Cross-Sectional Survey of IV Fluid Prescribing Practices |
| title_full_unstemmed | Are Further Interventions Needed to Prevent and Manage Hospital-Acquired Hyponatraemia? A Nationwide Cross-Sectional Survey of IV Fluid Prescribing Practices |
| title_short | Are Further Interventions Needed to Prevent and Manage Hospital-Acquired Hyponatraemia? A Nationwide Cross-Sectional Survey of IV Fluid Prescribing Practices |
| title_sort | are further interventions needed to prevent and manage hospital acquired hyponatraemia a nationwide cross sectional survey of iv fluid prescribing practices |
| topic | hyponatraemia fluid therapy intravenous fluids prescribing practice knowledge |
| url | https://www.mdpi.com/2077-0383/9/9/2790 |
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