Please use this identifier to cite or link to this item: http://hdl.handle.net/1893/27296
Appears in Collections:Faculty of Social Sciences Journal Articles
Peer Review Status: Refereed
Title: How and why are subcutaneous fluids administered in an advanced illness population: a systematic review
Author(s): Forbat, Liz
Kunicki, Natalie
Chapman, Michael
Lovell, Clare
Contact Email: elizabeth.forbat1@stir.ac.uk
Keywords: advanced illness
hydration
hypodermocylsis
palliative care
subcutaneous
systematic review
Issue Date: 31-May-2017
Date Deposited: 28-May-2018
Citation: Forbat L, Kunicki N, Chapman M & Lovell C (2017) How and why are subcutaneous fluids administered in an advanced illness population: a systematic review. Journal of Clinical Nursing, 26 (9-10), pp. 1204-1216. https://doi.org/10.1111/jocn.13683
Abstract: Aims and objectives To identify the mechanisms of subcutaneous fluid administration in advanced illness. Background Hydration at end of life is a fundamental issue in quality care internationally. Decision‐making regarding the provision of artificial hydration in advanced illness is complicated by a paucity of evidence‐based guidance. Despite considerable attention given to the topic including two recent Cochrane reviews, there has been no focus in systematically identifying papers that report the mechanisms for delivering hydration subcutaneously. Consequently, there is a need to produce guidance on the site, mode, volume and rate of infusion, based on empirical evidence. Design Systematic review of papers reporting empirical research data. Methods Key databases (CENTRAL, Medline, EMBASE, Web of Science, CINAHL) were searched in September 2015, with no date limitations. Inclusion criteria focused on hypodermoclysis in adults within an advanced illness population. Selected studies were reviewed for quality and a risk‐of‐bias assessment was conducted for the included studies. Results Fourteen papers were included in the analysis; most (n = 8) were conducted in hospices with others (n = 6) in long‐stay units with a population affected by chronic conditions associated with ageing. Studies were of moderate or high quality. The site and mode of infusion were not well described in these papers, and rates of infusion varied widely allowing for little clear consensus to guide clinical practice in the administration of subcutaneous fluids. Conclusions Studies under‐report the mechanisms by which artificial hydration is provided, creating a paucity of evidence‐based guidance by which to practice. There is a need for evidence generated from nonmalignant populations to ensure applicability to the large number of people with other advanced illness. Relevance to clinical practice In the absence of sufficiently powered robust evidence, the mode of delivery of artificial hydration at end of life remains in the gloaming between evidence and unfounded habit.
DOI Link: 10.1111/jocn.13683
Rights: The publisher does not allow this work to be made publicly available in this Repository. Please use the Request a Copy feature at the foot of the Repository record to request a copy directly from the author. You can only request a copy if you wish to use this work for your own research or private study.
Licence URL(s): http://www.rioxx.net/licenses/under-embargo-all-rights-reserved

Files in This Item:
File Description SizeFormat 
JCN_subcut fluids.pdfFulltext - Published Version160.97 kBAdobe PDFUnder Permanent Embargo    Request a copy

Note: If any of the files in this item are currently embargoed, you can request a copy directly from the author by clicking the padlock icon above. However, this facility is dependent on the depositor still being contactable at their original email address.



This item is protected by original copyright



Items in the Repository are protected by copyright, with all rights reserved, unless otherwise indicated.

The metadata of the records in the Repository are available under the CC0 public domain dedication: No Rights Reserved https://creativecommons.org/publicdomain/zero/1.0/

If you believe that any material held in STORRE infringes copyright, please contact library@stir.ac.uk providing details and we will remove the Work from public display in STORRE and investigate your claim.