Subcutaneous fluid administration and site maintenance

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Abstract
As nurses working with older patients, the authors noticed a marked increase in the use of subcutaneous fluid administration as an alternative to the more traditional intravenous route, as a means of managing hydration in certain patients. The authors of this article noted an increase in the use of subcutaneous fluid administration (SFA) for older people in their trust. This increase had not been without its problems. Care of this client group was carried out at two separate hospitals in the trust. One hospital in particular had noticed the occurrence of several site abscesses of unknown origin; although swabs had been sent for microbiology, culture and sensitivity, there was no obvious connection between them. It was also identified that there was a difference of practice in the use of hyaluronidase between the two areas, with one hospital adding it to the infusion bag and the other putting it into the site via the butterfly. Additionally, after further discussion with the nursing staff, it became apparent that the use of SFA was new to most of them, and that there was little knowledge underpinning their practice as there were no practice guidelines.

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