Introduction to Fluid Stewardship

Intravenous (IV) fluids are commonly prescribed drugs in healthcare. However, inappropriate fluid administration is associated with higher morbidity and mortality. Fluid stewardship is defined as a series of coordinated interventions for judicious IV fluid administration, with a primary goal of limiting the deleterious effects of inappropriate fluid prescription and fluid overload or accumulation and optimizing the clinical outcomes. The success of Stewardships in healthcare can achieve success by strategy and policy development, designing overarching systems, encouraging collaboration and ensuring robust governance and accountability processes. The components of fluid stewardship are optimum fluid prescription (5Ps of the fluid prescription), comprehensive fluid guidelines, continuous staff education and an audit or quality improvement framework. The optimum fluid prescription includes the 6 D’s (definitions, diagnosis, drug, dose, duration, de-escalation and documentation at discharge) of IV fluid administration.