A case study of IV practice in a General Hospital.

Setting

The study was conducted to identify functional issues related to IV therapy in hospitals.

The research was conducted in 5 general wards in the hospital out of the 12 in total. Four wards were reserved for people having fever and other common ailments. One was especially for women and one for people who had injuries and minor operations. Each of the wards had 50 beds approximately. A single day in the ward has 3 nursing shifts and the day starts with bead preparation by the nursing assistants. They check the injection charts and give them medicines and advise them the time and details for the entire day. After breakfast time, the doctor's rounds start when each patient is checked for improvements. The details are added to the patient's record book. Timely IV therapy is also done for each patient after checking the drip charts and records.

Methodology

Activity Theory was used as a framework for understanding the hospital setting. As a part of the research, the information and action flow between different processes in the network was analyzed and the event causing an interruption in the flow was noted down. The research was done through casual observation and interviews with stakeholders including nurses, patients, by standers etc in the setting.

Insights

Nurses were overburdened with work due to high nurse to patient ratio and task associated with the maintenance of records for the hospitals. This leaves them with no time to monitor infusions, medication administration which is crucial as a part of the nursing care.

Majority of information flow regarding patients was done with the help of bystanders causing problems in information flow when they also had to do other tasks related to payment of fees procurement of medicines for patient etc in IP. There have been instances were IV drips were unmonitored leading to complications and bad patient experience in drips.

Patients on the other hand were reluctant to meet nurses more often even-if they had difficulty related to IV medications as they felt most of the nurses are busy.