Background: In Australia, midwives are integral to providing safe and supportive care to women in labour. The administration of intravenous (IV) fluids is a frequent clinical intervention performed by midwives. At present, practices surrounding IV fluid administration to women during labour within Australia are largely undescribed and there is a limited amount of robust evidence available to guide practice. IV fluids do carry a risk of harm. To define and ensure safe IV fluid practices, research into practices surrounding the administration of IV fluids to women in labour is essential.
Aims: To describe the current practice for registered midwives administering IV fluids to women during labour.
Design: Retrospective clinical chart review and fluid balance documentation audit.
Methods: A retrospective clinical chart review and audit of fluid balance documentation for 107 nulliparous women was conducted at a single metropolitan tertiary referral hospital in Sydney, New South Wales between 1 October 2016 and 22 March 2017. A 24-point tool was developed to audit fluid balance charts. Results: Eighty-eight percent of the 88 fluid balance charts available scored 50% or less using the 24-point fluid balance chart audit tool. Additionally, there was an estimated 18% completion rate for the NSW IV fluid order chart.
Conclusion: This study found wide variation in clinical practice and incomplete fluid balance documentation at a single, metropolitan tertiary referral hospital. The findings highlight the difficulty of determining IV fluids practices in the context of incomplete fluid balance documentation. Additionally, there are patient safety and professional regulation concerns when fluid management documentation is missing and/or incomplete. Future research should examine barriers and facilitators for documentation.