Administration of Subcutaneous Fluid

Hampshire Community Health Care
Version 1.00
ADMINISTRATION OF SUBCUTANEOUS
FLUIDS (HYPODERMOCLYSIS) TO ADULT
PATIENTS IN COMMUNITY SETTINGS
GUIDELINES
Administration of Subcutaneous Fluids Guidelines
Page 1 of 28
Title:
Version 1.00
GUIDELINES FOR THE ADMINISTRATION

OF SUBCUTANEOUS FLUIDS
(HYPODERMOCLYSIS) TO ADULT
PATIENTS IN COMMUNITY SETTINGS
Summary:
To provide guidance to registered nurses on

the safe administration of subcutaneous fluids
to adult patients in the community for the
management of symptoms of dehydration
Policy Reference Number:
HCHC/CLI/95/V1.00
Version Number:
1.00
Target Audience:
All employees of the Hampshire Community

Health Care (HCHC)
Review Date:
March 2014
Approved by:
Date of meeting:
Policy Management
Group
Ratified by:
16/03/11
Date of meeting:
Quality and Governance

Committee
05/04/11
Date Issued:
April 2011
Author:
S Coopey (Adapted from the Leeds PCT

guidelines)
Custodian:
Sue Harriman
Signed Chief Executive
Date:
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Document Control
Change Record
Date
Author
Version
Reason for Change
Reviewers/contributors
Name
Steve Mennear
Tina Baker
Carol Mayl
Michelle Morron-Ryan
Janet Holden
Vicky Melville
Debbie Wakeford
Suzie Ingram
Position
Lead Pharmacist
Version Reviewed &

Date
Veresion2 (1/2/11)
Veresion2 (1/2/11)
Veresion2 (1/2/11)
Veresion2 (1/2/11)
Veresion2 (1/2/11)
Veresion2 (1/2/11)
Veresion2 (1/2/11)
Veresion2 (1/2/11)
Community Matron
Modern Matron
Community Matron
Community Matron
Clinical trainer
Distribution
Name
Community matrons
Modern Matrons
Community Care Teams
Position
Version Distributed &

Date
Veresion2 (1/2/11)
Veresion2 (1/2/11)
Veresion2 (1/2/11)
Page 3 of 28
Version 1.00
POLICY DEVELOPMENT DOCUMENT CONTROL PANEL
Title: GUIDELINES FOR THE ADMINISTRATION OF SUBCUTANEOUS FLUIDS

(HYPODERMOCLYSIS) TO ADULT PATIENTS IN COMMUNITY SETTINGS
Version Number: 1.00
Date of Issue: April 2011
Review Date: April 2014
Policy Developer (Author): S Coopey
Policy Developers designation: Practice Development Nurse Specialist
Policy Developers contact details: Mobile 07876136718 email: steve.coopey@hchc.nhs.uk
(including email address)
File name and document pathway:
(i.e. P\general\.....)
Is this a New Policy?
Yes
If Yes, why is it required?
(i.e. new legislation necessitating HCHC compliance)
If No, name of current Policy under review :
(if different from above)
If No, reason for reviewing current policy:
(i.e. Policy review date expiring, change in legislation necessitating policy amendment)
Who has been involved/consulted in order to develop this Policy?

This policy has been developed from the Leeds PCT policy
How does the Policy link to:
Standards for Better Health identify which Standard:
National Service Framework for Older People to avoid age
discrimination and promote positive attitudes to older people:
Have you considered in your Policy development the impact of your Policy on:
Health and Safety at Work etc. Act 1974
Yes
Sex Discrimination Act 1975
Yes
Race Relations Act 1976
Yes
Human Rights Act 1998
Yes
Disability Discrimination Act 1995
Yes
Freedom of Information Act 2000
Yes
Environmental Information Regulations 2004
Yes
Re-use of Public Sector Information Regulations 2005
Yes
Race Relations (Amendment) Act 2000
Yes
Civil Contingencies Act 2005
Yes
Mental Capacity Act 2005
Yes
Other (please specify):
Policy Ratification
Joint Staff
Professional
Trust Board
Committee
Executive
Committee
Date submitted to:
Date re-submitted (if applicable):
Date approved:
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Version 1.00
Contents page
1 Introduction
2 Status
3 Scope
4 Definitions
5 Ethical issues
6 Resources and equipment
7 Rehydration in older people
8 The Use of Fluids Licensed for Intravenous Use
9 Advantages
10 Disadvantages
11 Sites
12 Choice of cannula
13 Fluids
14 Use of Hyaluronidase
15 Monitoring the infusion
16 Documentation
17 Training
18 Audit and Monitoring
19 References
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Appendix
1. Procedure for the administration of subcutaneous fluids
2. Infusion record
3. Competency tool
4. Training needs analysis
5. Equality Impact tool
14
16
17
21
22
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1. Introduction
This guideline identifies the principles and procedures for the management of subcutaneous fluids to
adult patients for the management of symptoms of dehydration.
2. Status
This is a clinical guideline
3. Scope
The contents of this document apply to all Registered Nurses working within Hampshire Community
Health Care (HCHC).
4. Definitions
Hypodermoclysis
Hypodermoclysis is a technique used for the subcutaneous administration of large volumes of fluids
and electrolytes in order to achieve fluid maintenance or replacement in mildly dehydrated patients for
whom intravenous access may be difficult to obtain, or who cannot tolerate sufficient oral intake
Hypodermoclysis can be considered for use in patients with:
Life-limiting conditions
Difficulty maintaining oral hydration
Mild to moderate dehydration
Difficult venous access
Stroke, palliative care and cognitive impairment
Hypodermoclysis should not be considered for the following:
Children
Patients experiencing severe dehydration (where IV fluids are required)
Severe Renal Failure
Severe Hepatic Failure
Hypercalcaemia
Shock or poor tissue perfusion
Any patient for whom fluid balance management requires accurate and intensive monitoring
If > 3 Litres fluid to be administered over 24 hours
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5. Ethical issues
Patients who are in the last few days or weeks of life are often unable to tolerate oral hydration. The
prime goal of any treatment towards the end of life must be the comfort of the patient. Considerations
around how to approach the issue of hydration at the end of life are complex and involve not only
physical, psychological and social concerns, but also ethical dilemmas. (Salt, S. 2007). A review of the
literature continues to give conflicting views as to the role and effectiveness of hypodermoclysis and a
comprehensive reading list is provided in this guideline for those interested in further information
regarding these views. In summary there are two schools of thought those who believe artificial
hydration for this group of patients is unnecessary, not beneficial and potentially harmful, whilst others
contend that dehydration in patients who are dying can be extremely distressing and should be given
the same priority in terms of symptom control as is given to the control of pain, nausea and vomiting
etc.
Whilst it is important that clinicians have information about the latest evidence base regarding
hypodermoclysis so that they can contribute to the decision making process about whether or not to
use subcutaneous hydration for a dying patient, the purpose of this guideline is to support clinicians in
the safe delivery of subcutaneous fluids.
In order for the patient to give their informed consent (which can be written or verbal), they need to
have a clear understanding of:
What the subcutaneous fluids are being used for (with particular reference to them being used
off license)
The purpose of administering them
How the decision will be made to stop the infusion (if appropriate)
It is important that the practitioner understands the reasons behind the decision for each individual
patient so that she (he) is able to discuss this with the patient/carers/family as required. It is also
important that the situation is constantly reassessed in terms of whether the hydration regime is helping
to relieve symptoms.
Where a patient may lack capacity to consent to hypodermoclysis and the treatment is considered in
their best interests practitioners will need to refer to the guidance contained in the Mental Capacity Act
2005 Code of Practice.
6. Resources and Equipment
Fluids for infusion

Administration sets
Drip stands
Butterfly/ cannula
Semi-permeable film dressing
Sharps bin
Documentation/infusion record
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7. Rehydration in Older People

Dehydration can be a common problem in older people. Acute problems such as mild infections,
vomiting and diarrhoea, temporary confusion due to change in medication could all precipitate
dehydration because an adequate fluid intake cannot be maintained (Ferry et al, 1999). For older
people with mild dehydration or at risk from mild dehydration subcutaneous fluids are a safe
intervention that could potentially prevent the need for hospitalisation.
8. The Use of Fluids Licensed for Intravenous Use

The solutions outlined in these guidelines are only licensed for use intravenously. Therefore the use of
these subcutaneously is an unlicensed procedure (or being used off-license). The effective use of
infusion fluids in this way has been well documented and the prescriber will be conversant with such
evidence. It is important that the patient is made aware of this issue as it forms part of the consent
required for the procedure.
As the fluids are to be used off license, only a medical prescriber can prescribe these fluids. A Clinical
Management Plan (CMP) will be developed for use by Independent Non Medical Prescribers (NMPs).
9. Advantages
The infusion is usually easier to set up than intravenous (IV) fluid therapy and can be set up by
a nurse in almost any setting
It does not cause thrombophlebitis
It is often better tolerated by the patient
It can be discontinued and commenced with no ill effects, as part of the patients management
plan (e.g. where patients are mobile and active)
It can be administered in the patients own home or nursing and residential care homes, thus
possibly preventing hospital admission or enabling speedier discharge
10. Disadvantages
It is not appropriate in severe dehydration

A limited volume or range of fluids can be administered
There is a small risk of inflammation
Local oedema can occur and be associated with a feeling of tightness and discomfort. This
normally clears within a few hours and causes no permanent ill effects
The infusion can dislodge easily
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11. Sites
The site for placement of the cannula should be chosen with consideration to the
following:
Limiting the potential for jostling of the cannula in situ

Loose subcutaneous tissue will allow for the ease of administration of large volumes of fluid
Patient comfort and safety
The need to mobilise
Lucidity/confusion of the patient
The abdomen, chest and lateral aspects of the upper arm or thigh are recommended sites. The following
areas should be avoided:
Areas of lymphoedema or ascites as absorption will be restricted and breaches in skin integrity
could increase risk of infection
Bony prominences
Recently irradiated skin sites
Joints and skin folds
Sites of tumour
Areas of broken skin
Areas of inflammation or infection
Areas where medication patches or other topical applications are in place
The subcutaneous needle should be changed every 48 hours.
If resiting and need to use same area, the needle must be at least 3cm away from problem site.
12. Choice of Cannula

Choice of cannula should take into account the specific needs of the patient.
A cannula with a safety system such as BD saf-T-Intima should be used.
13. Fluids
Fluids that can be administered by hypodermoclysis:
Sodium chloride 0.9% or 0.45%
Dextrose (Glucose) 5%
Dextrose saline (Glucose 4% with sodium chloride 0.18%)
Potassium infusion of no more than 20mmol/L (pre-prepared infusion e.g. potassium chloride and
sodium chloride infusion)
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When administering the above fluids under no circumstances should any medications be
added to them.
Under no circumstances should any other fluids (other than those mentioned) be
administered via the subcutaneous route.
Special precautions:
Sodium chloride infusion:
Maximum 3 litres in 24 hours
Maximum 2 litres using a single site
Dextrose (Glucose) 5% infusions:
Maximum2 litres in 24 hours
Regular monitoring of the site to look for early signs of irritation and inflammation due to acidic pH
of glucose
Potassium infusions:
Maintain strict site observation because of risk of irritation
Do not exceed recommended concentrations
Sodium chloride 0.9% would normally be used where the patient is suffering electrolyte losses such as
gastro-enteritis.
Dextrose (Glucose) 5% is more commonly used where dehydration is present due to fluid losses
exceeding intake such as coma and dysphagia.
Regimens using both Dextrose (glucose) 5 % and saline in combination or saline 0.18% and glucose
4% (Dextrose saline), can be used where patients need both electrolyte and fluid replacement.
Injudicious use of the latter may cause hyponatraemia in the elderly.
The rate setting for 1 Litre over 12hrs will be 28 drops per minute (when using an administration set that
delivers at 20 drops /minute).
Volume of fluid (ml) x set value (drops/ml) /minutes = Flow rate (drops/min) duration (hr)
Fluids may also be infused more slowly, for example 1 Litre over 24 hours in which case the rate would
be 14 drops per minute.
The drip rate should be as per fluid prescription chart

Advice should be sought from the pharmaceutical advisor if asked to administer any other
fluid/or if asked to administer more quickly.
Fluids must be gravity fed and regulated (i.e. using a drip stand, giving set and calculating the drip rate)
and NOT infused using a pump (Hypodermoclysis working Group 1998)
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14. Use of Hyaluronidase

Hyaluronidase is an enzyme, which assists and speeds up the absorption of subcutaneous fluids.
Hyaluronidase may be of benefit to patients in whom sites become quickly oedematous (often those
with cachexia).
The use of Hyaluronidase is not routinely necessary and can cause local irritation or systemic allergic
reactions.
A daily dose of 1500 units is administered subcutaneously into the site before starting the infusion. It
can be used if more than two litres of fluids are infused over 24 hours or an infusion rate of more than
one litre in 8 hours (2ml/min).
15. Monitoring the Infusion

The infusion site must be checked every shift/ on each visit. The infusion must be checked to ensure it
is maintaining a continuous regular fluid flow at each nursing intervention. Observations of the infusion
site as well as ensuring that the infusion is running to time must be recorded in the patients notes at
each visit. The site must be checked for signs of redness, swelling, tenderness or leakage around the
entry site and the infusion site should be renewed if these symptoms occur. If reactions occur, consider
the following;
Change the infusion cannula to non-metallic type
Change the type of site dressing
Although it is anticipated that patients with an infusion of subcutaneous fluids in situ will be receiving
frequent visits from clinicians over a 24 hour period, there are some exceptions to this. It is not
necessary for clinicians to visit specifically to check the
infusion if the patient does not require more frequent visits for whatever reason. Monitoring can be
delegated to a carer provided they are given the appropriate training/information. Clinicians should use
their professional judgement to decide frequency of monitoring and visits and ensure, where
appropriate, that relatives and carers are advised on how to detect any problems with the infusion and
given contact numbers for reporting these. Relatives and cares should be provided with written
information/ leaflet to support the nurse instructions.
16 Documentation
Documentation in the patients nursing record should contain complete information regarding infusion
therapy (INS 2000; ICNA 2000), and should comply with the guidelines for record keeping (NMC 2008).
This should include:
evidence of consent (or other measures taken where a patient lacks capacity)
date and time of insertion/commencement of therapy and site
rate of infusion, and fluid being infused
evidence of consequent monitoring to include report on site check, rate of infusion, patients
tolerance of therapy
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discontinuation of therapy(including date/time and volume infused) and document the reason for
discontinuation - either due to completion, adverse reaction, patient decision/choice or if the
infusion is considered to be no longer beneficial.
signature and printed name
Staff should use the infusion record for the administration of subcutaneous or intravenous fluids
(Appendix 2)
17. Training Needs

Hypodermoclysis can be commenced by any registered nurse who is capable of administering
subcutaneous injections and insertion of a subcutaneous needle.
There is no formal training within HCHC for this area of practice as it is considered unnecessary. This is
because the clinical skills staff need to site a subcutaneous needle and to care for an infusion site are
covered in existing training provision (syringe driver training). Additional knowledge requirements are
covered within this policy.
However, it is recognised that this is a new area of practice for many staff so to support staff in gaining
confidence a competency framework has been developed (see Appendix 2). This can either be used as
a self assessment tool or to support colleagues within the team to gain competence.
Any registered nurse required to administer subcutaneous fluids to a patient should ensure they have
the knowledge, skills and competence. Staff are encouraged to support less experienced colleagues to
gain skills and competence where necessary This may include visiting the patient in hospital/ hospice
prior to discharge or another community team to learn from colleagues.
18. Audit and Monitoring

Adherence to this guideline will be monitored through incident reporting within HCHC.
The above measures will not only inform of any potential training needs but may also contribute to
ongoing research into the ethical issues surrounding the use of this treatment.
19. References
Hypodermoclysis working group. Hypodermoclysis : guidelines on technique.1998. Wrexham: CP
Pharmaceuticals (111)
Intravenous Nurses Society (INS,2000) Standards for Infusion Therapy. Cambridge, MA ins AND
Becton Dickinson (III)
Infection Control Nurses Association (ICNA, 2000) Guidelines for preventing intravascular catheterrelated infections. Fitwise Publications (III)
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Nursing and Midwifery Council (2008) The Code - Standards of conduct , performance and ethics for
nurses and midwives
Nursing and Midwifery Council (2008) Standards for Medicines Management
Nursing and Midwifery Council (2008) Record Keeping Advice Sheet
Salt, Susan. (2007) When a terminal patient is no longer able to eat or drink. End of Life Care, 2007,
Vol1, No. 3
The Mental Capacity Act 2005 Code of Practice
Reading List
Campbell, C. Partridge, R. (2007) Artificial Nutrition and Hydration Guidance in End of Life Care for
Adults. National Council for Palliative Care. London
Dunphy K, Finlay I, Rathbone G & Hicks F (1995) Rehydration in palliative care: if not - why not?
Palliative Medicine 9: 221 - 228
Fasinger RL, MacEachern T, Miller MJ, Bruera E, Spachyski K, Juehn N & Hanson J, (1994) The use of
hypodermoclysis for rehydration in terminally ill cancer patients. Journal of Pain and Symptom
Management 9 (5); 298-302.
Ferry M, Daradire V & Constans T (1999). Subcutaneous infusion of hypodermoclysis : a practical
approach. Journal of the American Geriatrics Society;47:93-95.
Gill S, Daspupta M & Rochon P(2001) Hypodermoclysis for dehydration. American Family
Physician;64:9,1516-1518.
Lanuke, K. Fasinger, R.L. (2003) Hydration management in palliative care settings a survey of
experts. Journal of Palliative Care. 19 (4): 278-9
Morita, T. Hyodo, I. Yoshimi, T. et al (2006) Artificial hydration therapy, laboratory findings, and fluid
balance in terminally ill people with abdominal malignancies. Journal of Pain and Symptom
Management 31(2): 130-9
Steiner,N , Bruera,E (1998) Methods of Hydration in Palliative care patients. Journal of palliative
care,14 (2) 6-13 Summer.
Jilek R. (1999) Subcutaneous Fluid Administration: An effective alternative to intravenous therapy.
Geriatrician; 17 (1) 16-18.
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Appendix 1
Procedure for the administration of subcutaneous fluids
Action
1. Identify the patient correctly using name, date of
birth, NHS number and wristband
2. Explain the procedure to the patient and/or
carer, allowing time for any questions. Ensure they
understand the use of IV fluids for subcutaneous
use is unlicensed but best/accepted practice and
have the required information for monitoring.
3. Assess the patient for a suitable site. (See 11.0
above)
4. Before administering any prescribed fluid check
that it is due and has not already been given.
5.Check the fluid against the prescription chart and
ascertain and record the following:
a) prescription is valid
b) fluid name, strength and volume
c) batch number and expiry date
d) infusion route and rate.
6. Check expiry date and integrity of the fluid
container to be used. Check infusion fluid for
discolouration/ crystalline or particulate matter.
Prepare the fluid for infusion by inserting line into
infusion bag and priming line with fluid
7. Clean the injection site with swab saturated with
70% Isopropyl alcohol for 15 30 seconds and
allow to dry.
8. Introduce the Butterfly needle/ peripheral
cannula at the angle recommended by the
manufacturer bevel up.
Technique gently pinch a well-defined
amount of tissue between the index finger and
thumb and insert the needle into the base of
the pinch.
9. If blood appears in the line on insertion of the
needle, withdraw immediately and repeat the
process in a different site.
10.Coil the tubing and secure with a semi
permeable film dressing e.g. Tegaderm
Rationale
To identify the right patient
To ensure the patient/family are fully informed
and to gain valid consent where appropriate
To provide a comfortable and safe area for fluid

absorption
To protect the patient from harm.
To ensure that the correct type and quantity of
fluid are administered by the correct route
To protect the patient from harm
(NMC May 2008)
Standards for Medicines Management (NMC
2008)
To prevent an ineffective or toxic compound
being administered to the patient.
To check that no contamination has occurred
To reduce the risk of site contamination
To ensure the needle lies in the subcutaneous

space
To prevent infusion into a blood vessel
To prevent kinking. To secure the line and

prevent contamination
N.B If the patient is also receiving

subcutaneous medication via a syringe driver,
it is advisable to mark the lines to differentiate
between the two infusions
11. Set the infusion at the prescribed rate
To ensure the fluid is infused correctly
12. Dispose of sharps safely in yellow Sharps bin.
Prevention of needle stick injuries
13. Monitoring at each visit:
To identify signs of infection / prevention of
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Check infusion site for signs of redness, swelling,

tenderness or leakage around the entry site and
record that you have checked.
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complications
Check volume remaining is (approximately) correct

for the prescribe volume and administration rate
i.e. is running to time, and record that you have
checked.
Check for any signs of blood in the administration
set, plastic cannula or butterfly needle.
If any of the above are present and
infusion incomplete, stop the infusion and
remove the cannula/needle.
Re-site the infusion in a different area
using a new cannula/needle. If sites are
restricted for any reason, re-site in the
same area but at least 3cm from the
original site of entry.
14. Record details of infusion in patient record /
medical notes to includedate and time commenced
observations of infusion site
signature
date & time discontinued
signature on the appropriate record (see App. 2)
and in the patients patient held records as
necessary.
To achieve the rate prescribed
To maintain accurate records. To provide a

point of reference in the event of any queries.
To prevent any duplication of treatment
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Appendix 2 Infusion record
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Appendix 3
Administration of subcutaneous fluids clinical competencies
Name:
Role:
Base:
Date initial training completed:
Competency Statement:
The participant demonstrates clinical knowledge and skill in the administration of subcutaneous fluids
without assistance and/or direct supervision (level 3)
See page 5 for level descriptors.
Performance Criteria
Assessment
Method
Level achieved
Date
Assessor/self
assessed
The Participant will be able to:

1.
Demonstrates practical skill in

the safe and effective
administration of
subcutaneous fluids, via a
Butterfly needle/soft set and
ongoing monitoring of the site
a) Explain the procedure to the
patient and/or carer, allowing
time for any questions. Ensure
they understand the use of IV
fluids for subcutaneous use
and have the required
information for monitoring
b) Assess the patient for a suitable
site.
c) Before administering any
prescribed fluid check that it is due
and has not already been given
d) Check the fluid against the
prescription chart and ascertain
and record the following:
1. Prescription is valid
2. Fluid name, strength and
volume
3. Infusion route and rate
e ) Check expiry date and integrity
of the container of the fluid to be
infused
Direct
observation
Direct
observation
Direct
observation
Direct
observation
Direct
observation
Prepare the fluid for infusion by

inserting line into infusion bag and
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Performance Criteria
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Assessment
Method
Level achieved
Date
Assessor/self
assessed
priming line with fluid

f) Ensure site is cleaned
Direct
observation
g) Introduce the Butterfly

needle/ peripheral cannula at
the angle recommended by
the manufacturer, bevel up.
h) Take appropriate action if
blood appears in the line on
insertion of the needle by
withdrawing immediately and
repeating the process above in
a different site
i) Coil the tubing and secure
with a semi permeable film
dressing
j) Set the infusion at the
prescribed rate
Direct
observat
ion
k) Dispose of sharps safely in

sharps bin
Direct
observation
l) Record details of infusion to

include:
observations of infusion site
signature
date & time discontinued
signature
on the HCHC infusion record (see
App. 2) and in the patients patient
held records as necessary
Direct
observation
Questioning /
Direct
observation
Direct
observation
Direct
observation
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Date all elements of Competency Tool completed to level 3_______
I confirm that I have attended initial training on _________and that I am confident and competent in
administration of subcutaneous fluids
Registered Nurse ______________ Signature _______________
Status ___________ Date
_______
I confirm that I have assessed the above named Registered Nurse and can verify that he/she
demonstrates competency in administration of subcutaneous fluids
Verifier
_______________Signature _______________Status
___________
Date ____
Review
Competent
Registered Nurse
Dates:
Yes / No
Signature
Verifier signature
Comments
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Levels of competency Rating Scale
Novice
Competent
Practitioner
Expert
Level of achievement
Cannot perform this activity satisfactorily to the
level required in order to participate in the clinical
environment
Can perform this activity but not without constant
supervision and assistance
Can perform this activity with a basic
understanding of theory and practice principles,
but requires some supervision and assistance
Can perform this activity with understanding of
theory and practice principles without assistance
and/or direct supervision
and/or direct supervision, at an appropriate pace
and adhering to evidence based practice
and adhering to evidence based practice.
Additionally demonstrating initiative and
adaptability to special problem situations.
and adhering to evidence based practice.
Demonstrate initiative and adaptability to special
problem situations, and can lead others in
performing this activity
Level
0
1
2
Adapted from: Herman GD, Kenyon RJ (1987) Competency-Based Vocational

Education. A Case Study, Shaftsbury, FEU, Blackmore Press, cited in Fearon, M.
(1998) Assessment and measurement of competence in practice, Nursing Standard
12(22), pp43-47.
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Appendix 4 - Learning & Development Training Needs Analysis

Within this template below you will have to clearly identify and describe which staff group require which training and at what frequency. So do consider all
options - for example qualified clinical: such as nurses, dental nurses, AHPs (OTs, physios & other therapists) including clinical managers,
unqualified/unregistered support workers, non clinical managers, other non clinical versions of the staff in the groups already listed, corporate staff including
senior staff such as Directors, plus administrative, clerical & estates etc. and contact L&D as soon as possible to agree training needs and to consider whether
this is a trust wide training requirement or whether this training is restricted to a local requirement. This must all be completed and agreed with L&D prior to
submission the policy board.
Type
of
Trainin
g
Target
Audience (by
division)
Frequency
Length
Delivery Method
Trainer
Recording
attendance
Strategic responsibility
Operational
responsibility
What
type of
training
is
required
?
Identify specific
staff groups who
need to attend
from each
Business Unit
How often will

staff need to
attend?
How long
will the
training
take?
How will the training

be delivered?
Who will deliver

the training?
Where are they

held, who records
attendance?
Who has ultimate

responsibility for the
training?
Who makes it happen?
Adult BU: All

staff (i.e.
registered/qua
lified clinical
staff and
unregistered
clinical
support staff)
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Equality Impact Assessment Tool
Name of policy
Directorate/ Department
Date Impact Assessment

Completed
GUIDELINES FOR THE ADMINISTRATION OF

SUBCUTANEOUS FLUIDS (HYPODERMOCLYSIS) TO
ADULT PATIENTS IN COMMUNITY SETTINGS
Adult services
Name of person / department who is accountable for this

Impact Assessment?
S Coopey
SCREENING
1
Identify the Main Aims of the Proposal
1.1 What is the purpose of this proposal?

Provide a brief overview of the proposal including the background, its purpose and scope, and
legal factors impacting on the policy. What does it try to achieve?
This policy sets out the standards and procedures for any member of staff , irrespective
of age, race, colour, religion, disability, nationality, ethnic origin, gender, sexual
orientation or marital status, domestic circumstances, social and employment status,
HIV status, gender reassignment, political affiliation or trade union membership
To provide guidance to registered nurses on the safe administration of subcutaneous
fluids to adult patients in the community for the management of symptoms of
dehydration
1.2 Who will be affected by the outcomes of the proposal?
Who is the policy aimed at? How will they benefit?
The contents of this document apply to all Registered Nurses working within Hampshire
Community Health Care (HCHC). The policy will be available to other staff
independently contracted to the trust
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COLLECT INFORMATION
It is important to have as much up to date and reliable information about the different groups the
proposal is likely to affect.
2.1
What data has been used to inform this Impact Assessment?
2.1a
First Level Data
If the main impact of the proposal is employees include demographic data.
Also detail in terms of age, gender, race, religion or belief, sexual orientation, disability.
If the main impact is patients and public, demographic data should be collated.
Second Level Data

(e.g., Grievances, disciplinaries, Complaints, risk events, consultation papers, feedback, national
guidelines, other impact assessments, local studies)
Monitored through Datix
2.2
Which stakeholders have been involved / consulted in the development of the
proposal?
(Those who are directly affected by the policy or external bodies with an interest in this proposals
impact.)
Community Care teams and Community hospital staff
2.3
How was involvement / consultation carried out?
Virtual discussion and via policy group
2.4
Summary of data/responses
No equality issues raised
A summary of all data is required here. Specific data relating to each equality strand will be
required within each equality review in the Full Assessment.
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DECIDING WHETHER THE PROPOSAL IS RELEVANT TO THE GENERAL DUTY
Based on the data given will this

policy / procedure:
Eliminate
discrimination?
Promote equality of
opportunity?
Race
yes
yes
Promote good
relations between
people of the
same or of
different groups?
yes
Religion and belief
yes
yes
yes
Disability
yes
yes
yes
Gender
yes
yes
yes
Age
yes
yes
yes
Sexual Orientation
yes
yes
yes
If an impact is anticipated a Full Assessment for the relevant equality strand will need
completing.
If no impact is anticipated go to section 7.
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Race Equality Review (including Religion and Belief)
4.1
State specifically which minority community are affected (or state all)?
travellers
asylum seekers
people for whom language is
a barrier
refugees
religious and faith groups
those involved in the criminal
justice system
those on low incomes
Other please state
4.2
4.3
immigrants
homeless people
People from different racial or
ethnic groups
What solutions have been implemented to mitigate or reduce this impact?
What is the anticipated impact of the proposal on the identified minority communities?
What further data has been used?

Results of involvement and consultation events, focus groups etc that have been implemented to gain
further understanding of this impact.
4.4 List the stakeholders involved in the development of these solutions
4.5 How was this involvement carried out?
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FULL ASSESSMENT
5 Disability Equality Review
5.1
Consider which disabilities are affected?
learning or development difficulty

sensory disabilities
mental health conditions

progressive long term health
conditions
Other please state
mobility disabilities
older people
5.2
What is the anticipated impact of the proposal on those people with a disability?
5.3
What solutions have been suggested to eliminate this impact?

5.4
List the stakeholders involved in the development of these solutions
5.5
How was this involvement carried out?
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FULL ASSESSMENT
6
Gender (include transgender issues), Age and Sexual Orientation Review
6.1
State specifically which people are affected (or state all)
men
women
boys
girls
lesbian
gay
bi-sexual
transgender
pregnant women
people with caring
other please state
responsibilities
6.2
What is the impact of the proposal on gender, age and sexual orientation issues?
6.3
What solutions have been suggested to eliminate this impact?

6.4
List the stakeholders involved in the development of these solutions
6.5
How was this involvement carried out?
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7.1
Version 1.00
Proposed Actions
It is proposed that the policy is implemented and disseminated to all managers and staff at the earliest
opportunity
7.2
How will the proposal be monitored?
The policy will be monitored through the Learning Management System.

The policy is to be reviewed routinely every three years or sooner in response to technical amendments
or as a result of changes in national / local guidance and/or legislation changes
7.3
What is the time frame for monitoring?
Every three years
7.4
Person/s responsible for proposed actions and review
Policy Group
7.5
Include a Glossary of Terms relating to this EQIA
7.6
Summary for Board Paper
This paper does not have any impact however will be monitored by Datix
Impact assessing this proposal will be an ongoing process
As more data becomes available it will be added to the Assessment as appropriate
Page 28 of 28

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Hampshire Community Health Care