Health system factors that affect intravenous fluid administration by nurses at a county referral hospital in Kenya

Abstract

Introduction: Many hospitalized patients receive intravenous fluids (IV) for replacement of body fluid losses and maintenance of proper fluid and electrolyte status. Proper clinical decision making, IV fluid administration and monitoring practices are critical in the prevention of complications related to IV fluid therapy. The objective was to identify the health system factors that affect the administration of intravenous fluids to patients by nurses at the medical and surgical wards at a County Referral Hospital in Kenya.

Methods: A descriptive cross-sectional study was conducted on nurses at the adult medical and surgical wards. Self-administered, semi-structured questionnaire was administered to the nurses. Data on the challenges encountered by the nurses in administration of IV fluids to the patients was collected. Relevant authorities granted approval to collect data.

Findings: Shortage of nurses (staffing) was the most significant health system factor (p=0.0001) in the administration of IV fluids to patients. Shortage of supplies (IV fluids and infusion sets) also affected IV fluid administration to patients (p=0.013)

Conclusion: Various health system factors affect administration of IV fluids to patients; with the most significant ones being shortage of nurses and supplies in the wards.