SC Fluids for palliative patients at home
Standard Operating Procedure and Prescription/Administration Chart
Primary care prescribers who wish to prescribe subcutaneous (SC) fluids should refer to the Scottish Palliative Care Guidelines on Subcutaneous Fluids here. A multidisciplinary group in NHSGGC has produced a Standard Operating Procedure (SOP) for community nurses when caring for palliative patients in their own home or in a homely setting. This SOP and supporting information is available here and includes (in addition to the SOP):
- Information leaflet for patients, carers and relatives
- Adult subcutaneous fluid prescription and administration chart - partnerships/community nursing
Please note, patients living in care homes are out with the scope of this SOP.
The SOP requires that, before a decision to prescribe fluids is made, the patient should be jointly assessed by the GP, community nurse and other members of the team providing care. Fluids must be prescribed on the adult subcutaneous fluid prescription and administration chart by a GP or competent non-medical prescriber.
Obtaining fluids & sundries
When patients are managed in line with this SOP, a GP10 prescription for fluids is not required. The required fluids and sundries are held and accessed by community nursing staff at agreed bases in each HSCP/Locality.
Reminder - Unlicensed and off label prescribing in NHSGGC
The fluids used for SC fluid replacement have a product license for the intravenous (IV) route only. Therefore, SC fluid administration must be considered an unlicensed procedure (or being used “off-label”), and use must be in line with the principles of the NHSGGC Unlicensed Medicines Policy.
If you require further information, email prescribing@ggc.scot.nhs.uk.
Published 22/06/2020. Medicines Update blogs are correct at the time of publication.