Table 2 Summary of expert consensus on intravenous fluid management

Best practices are available but regular staff training and institutional buy-in is necessary to consistently achieve better fluid management practices

Develop institutional strategies and protocols, including education, to improve adherence to current guidelines

Limit availability and usage of specific IV fluid preparations (multi-electrolyte solutions) based on clinical setting to reduce confusion and errors

Use key performance indicators to track fluid management practices

Consistent fluid management education may be locally inconsistent

Position fluid management as an interesting topic, and as a pharmacologic prescription (similar to antibiotic stewardship practices)

Address distinct fluid delivery strategies for resuscitation, replacement, and maintenance therapy

Expand patient and/or caregiver education in order to emphasize the importance of appropriate fluids and to track symptoms

Standardize the approach to fluid prescription and fluid use across a country or countries

Select fluid ambassadors to lead and disseminate the knowledge

Consider posters, print sheets, e-learning opportunities, live learning events, podcasts, or symposia

Consider new technology such as patient simulators for fluid management

Institutional buy-in and oversight is needed to implement and maintain effective fluid stewardship

Identify fluid stewards and ambassadors with effective leadership and communication skills

Track outcomes to demonstrate the cost-effectiveness of appropriate fluid stewardship