People in hospital will often have problems maintaining their balance of fluids or electrolytes (minerals responsible for blood chemistry, muscle action and other cell processes). It is thought that the number of people on fluid and/or electrolyte drips, also known as IV drips, could number in the thousandsⁱ. As many as 1 in 5 may suffer complications due to the inappropriate administration of fluids, with deaths in some rare casesⁱⁱ.

In a new standard, NICE has issued 4 statements aimed at ensuring adults who need IV drips get the safest possible care. This includes ensuring hospitals have an expert lead responsible for promoting best practice and training other healthcare professionals on properly prescribing and administering IV fluids.

In a separate new standard NICE has issued priorities for diagnosing and treating people with varicose veins in their legs. Up to a third of the UK adult population are affected by varicose veins. In many people they cause no noticeable symptoms but in others varicose veins can cause pain, aching or itching and have an adverse impact on their quality of life.

The standard includes 3 statements highlighting the need for referral when varicose veins begin to cause symptoms or complications and also details newer therapies to be offered that are less invasive than surgery. These newer therapies, such as the heat energy treatment called endothermal ablation, promote faster recovery and need shorter hospital stays.

Professor Gillian Leng, Deputy Chief Executive and Director of Health and Social Care at NICE, said: “Our quality standards aim to help healthcare professionals in the NHS pinpoint the areas where improvements are most needed to provide the best care for patients. With the new standard for IV fluid therapy, we hope to make sure that every patient, wherever they are, can be confident that they will be treated safely and effectively during their stay in hospital. With our standard for varicose veins, we are highlighting the right tools and treatments healthcare professionals should use to help improve symptoms for affected patients.”

Ends

Notes to Editors

References

1. There are no definite figures for the number of people in hospital who require intravenous fluid therapy because these are not collected centrally. However, it is a common-place treatment with thousands of people likely to receive it during a hospital stay.

2. This figure is taken from a 1999 report by the National Confidential Enquiry into Perioperative Deaths(NCEPOD) that found a significant number of hospitalised patients were dying as a result of the infusion of too much or too little fluid.

In 2011, a NCEPOD report found that one in five hospital patients who received too little fluid management (8 out of 39 people) and one of 3 patients who received excessive amounts of IV fluids before surgery died within 30 days of having their procedure.

Another NCEPOD report from 2010 found that, of the people receiving parenteral nutrition and additional IV fluids in hospital (75% of the patients involved in the research), nearly one in three (28%) was being given the wrong volume of IV fluids.

About the draft quality standard / quality standard

1. The quality standard for intravenous fluid therapy in adults in hospital will be available at http://www.nice.org.uk/guidance/QS66 from 14 August 2014.

2. The quality standard for varicose veins in the legs will be available at http://www.nice.org.uk/guidance/QS67 from 14 August 2014. 

About NICE quality standards

NICE quality standards aim to help commissioners, health care professionals, social care and public health practitioners and service providers improve the quality of care that they deliver.

NICE quality standards are prioritised statements designed to drive measurable quality improvements within a particular area of health or care. There is an average of 6-8 statements in each quality standard.

Quality standards are derived from high quality evidence-based guidance, such as NICE guidance or guidance from NICE accredited sources, and are produced collaboratively with health care professionals, social care and public health practitioners, along with their partner organisations, patients, carers and service users.

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About NICE

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