BMJ Qual Improv Report 6: doi:10.1136/bmjquality.u213676.w7336
  • BMJ Quality Improvement Programme

Hypokalaemia: Addressing human factors and improving education around prescription and administration of Intravenous(IV) Potassium infusion in Trauma and Orthopaedics

  1. Gavin Love
  1. NHS Tayside, Scotland
  1. Correspondence to Vanushia Thirumal vanushia{at}
  • Received 31 October 2016
  • Revision requested 13 December 2016
  • Revised 30 December 2016
  • Published 31 March 2017


A high incidence of hypokalaemia was noted in Trauma and Orthopaedics of Ninewells Hospital. We sought to establish the reason behind this and implemented three PDSA cycles via questionnaires to 30 ward staff, both doctors and nurses over a 1 week period in December, February and July 2016. Key baseline measures include availability of IV fluids with 40mmol potassium on the wards, confidence prescribing or administering IV fluids with 40mmol potassium, necessity for cardiac monitoring during slow IV potassium replacement and recognition of confusion and learning need in this area. Interventions made include awareness and education session, departmental guideline, improving stock of IV fluids and hypokalaemia management pathway for mild, moderate and severe hypokalaemia. Post-intervention results showed 70% from 33% who said 40mmol IV potassium was available, 87% from 67% were confident prescribing or administering IV potassium and 70% from 27% were aware that cardiac monitoring was not necessary.

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