Reviews of the relevant published health economic literature identified in the literature search are presented alongside the clinical effectiveness reviews in the full version of the original guideline document (see the “Availability of Companion Documents” field). In addition, refer to Appendices L, M, and N in the full version of the original guideline document for cost sensitivity analyses of: Monitoring and assessment strategies for intravenous fluid therapy Types of intravenous fluids for resuscitation Intravenous fluids for routine maintenance Method of Guideline Validation External Peer Review Internal Peer Review Description of Method of Guideline Validation The guidance is subject to a six week public consultation and feedback as part of the quality assurance and peer review the document. All comments received from registered stakeholders are responded to in turn and posted on the National Institute for Health and Care Excellence (NICE) website when the pre-publication check of the full guideline occurs. Evidence Supporting the Recommendations Type of Evidence Supporting the Recommendations The type of evidence supporting the recommendations is not specifically stated. Benefits/Harms of Implementing the Guideline Recommendations Potential Benefits Appropriate management of intravenous (IV) fluid therapy for adults in the hospital setting to reduce morbidity and mortality and lead to better patient outcomes Potential Harms Complications of intravenous (IV) fluid therapy, including hyponatremia, volume overload, volume depletion and acute kidney injury (AKI) Qualifying Statements Qualifying Statements This guidance represents the view of the National Institute for Health and Care Excellence (NICE), which was arrived at after careful consideration of the evidence available. Healthcare professionals are expected to take it fully into account when exercising their clinical judgement. However, the guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or care givers, and informed by the summaries of product characteristics of any drugs. Implementation of this guidance is the responsibility of local commissioners and/or providers. Commissioners and providers are reminded that it is their responsibility to implement the guidance, in their local context, in light of their duties to have due regard to the need to eliminate unlawful discrimination, advance equality of opportunity and foster good relations. Nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties. The guideline will assume that prescribers will use a drug’s summary of product characteristics to inform decisions made with individual patients. Treatment and care should consider individual needs and preferences. Patients should have the opportunity to make informed decisions about their care and treatment, in partnership with their healthcare professionals. If someone does not have the capacity to make decisions, healthcare professionals should follow the Department of Health’s advice on consent External Web Site Policy, the code of practice that accompanies the Mental Capacity Act External Web Site Policy and the supplementary code of practice on deprivation of liberty safeguards External Web Site Policy. In Wales, healthcare professionals should follow advice on consent from the Welsh Government External Web Site Policy. NICE has produced guidance on the components of good patient experience in adult NHS services. All healthcare professionals should follow the recommendations in Patient experience in adult NHS services External Web Site Policy. For all recommendations, NICE expects that there is discussion with the patient about the risks and benefits of the interventions, and their values and preferences. This discussion aims to help them to reach a fully informed decision. Health care providers need to use clinical judgement, knowledge and expertise when deciding whether it is appropriate to apply guidelines. The recommendations cited here are a guide and may not be appropriate for use in all situations. The decision to adopt any of the recommendations cited here must be made by the practitioners, in light of, individual patient circumstances, the wishes of the patient, clinical expertise and resources.
