Standardization of Fluids in Inpatient settings (SOFI) – IV Fluids Project

Inappropriate use of intravenous fluids (IVF) may cause serious hospital-acquired harm, including iatrogenic dysnatremia with potential serious neurologic sequelae; pain and discomfort from multiple IV insertions and subsequent complications (e.g., IV infiltration); and inadequate or inappropriate monitoring for adverse effects.  There are currently no national benchmark data for IVF use in pediatric settings.  The AAP Clinical Practice Guidelines on maintenance IVF, released in late November 2018, contain one major recommendation: to use isotonic maintenance IVF in medical and surgical patients 28 days to 18 years old without pre-existing adrenal, cardiac, hepatic, neurosurgical, hematologic/oncologic and renal disease.   

This project sought to better describe and standardize the use of IVF in inpatient pediatric settings across the U.S. and evaluate the impact of an intervention bundle on maintenance IVF use.  In addition, since the use of peripheral IVs, IVF and laboratory draws are closely related in clinical practice, this project sought to improve health care value by reducing the number of routine laboratory draws.