Electrolyte and Fluid Imbalance: Clinical and System Reviews, Incident Analyses

Given the broad range of potential causes of electrolyte and fluid imbalance, clinical and system reviews should be conducted to identify potential causes and determine appropriate recommendations.

Occurrences of harm are often complex with many contributing factors. Organizations need to:

1. Measure and monitor the types and frequency of these occurrences.
2. Use appropriate analytical methods to understand the contributing factors.
3. Identify and implement solutions or interventions that are designed to prevent recurrence and reduce risk of harm.
4. Have mechanisms in place to mitigate consequences of harm when it occurs.

To develop a more in-depth understanding of the care delivered to patients, chart audits, incident analyses and prospective analyses can be helpful in identifying quality improvement opportunities. Links to key resources for conducting chart audits and analysis methods are included in the Hospital Harm Improvement Resources Introduction.

If your review reveals that your cases of fluid and electrolyte imbalance are linked to specific processes or procedures, you may find these resources helpful:

• Institute for Healthcare Improvement (IHI)
• Reduce Adverse Drug Events Involving Electrolytes
• How- to guide: prevent harm from high-alert medications. 2012
• Institute for Safe Medication Practice
• Targeted Medication Safety Best Practices for Hospitals. 
• High-Alert Medications in Acute Care Settings.
• National Institute for Health and Care Excellence (NICE) 
• Intravenous fluid therapy in adults in hospital: Clinical guideline [CG174] 
• Intravenous fluid therapy in adults in hospital: Quality standard [QS66]
• Ontario Regional Blood Coordinating Network: Bloody Easy for Healthcare Professionals.