Perceptions, challenges, and improvement strategies for reducing intravenous infusion use in hospitalised patients within Chinese medical institutions: a qualitative interview study.

backgroundIntravenous infusions are widely used in inpatient care, yet their overuse may increase safety risks, waste healthcare resources, and impose unnecessary burdens on patients. In China, where infusion use remains high, understanding the factors influencing efforts to reduce unnecessary intravenous infusion use is of clear clinical relevance. This study explored stakeholder perceptions, perceived barriers, and potential strategies for reducing unnecessary intravenous infusion use within the broader framework of standardised and rational infusion use.

methodsA qualitative study using semi-structured interviews was conducted with healthcare professionals and hospitalised patients. Purposive sampling ensured variation in participant roles, hospital levels, and demographic characteristics. Data were analysed using a hybrid qualitative approach, with inductive thematic analysis as the overarching framework and selected grounded theory coding procedures used to support code development, category construction, and theme refinement, rather than to generate a formal grounded theory.

resultsStakeholders showed varying levels of awareness regarding national expectations for standardised and rational intravenous infusion use. References by participants to "reducing infusion use" were interpreted cautiously as indicating uneven understanding or dissemination of the broader rational-use policy framework, including the reduction of unnecessary infusion, rather than lack of awareness of a reduction-specific national target. Physicians' prescribing decisions were influenced by clinical considerations, patient expectations, and medical insurance audit pressures. Nurses generally viewed reducing unnecessary infusion use as beneficial for improving workflow and reducing workload. Pharmacists highlighted both their important role in promoting rational drug use and the challenges they faced, including staffing shortages, limited training opportunities, and role ambiguity in clinical collaboration. Patients expressed mixed attitudes toward intravenous infusions, with some favouring them because of their perceived rapid effects and limited awareness of potential risks. Across stakeholder groups, reducing unnecessary infusion use emerged as a negotiation between clinical need, patient expectations, policy and insurance audit pressures, and the uneven authority and capacity of different professional groups. Strategy-related findings, derived mainly from healthcare professional accounts and contextualised by patient accounts of expectations, risk awareness, and acceptability, concerned strengthened education and training, better policy alignment, pharmacist capacity building, clinical pathway development, and interdepartmental collaboration.

conclusionThis study identified key barriers to reducing unnecessary intravenous infusion use within the broader framework of standardised and rational infusion use in Chinese medical institutions and highlighted stakeholder-informed strategies for improvement. The findings may inform quality-improvement efforts to promote more rational intravenous infusion use. Further research is needed to evaluate the effectiveness of specific interventions in practice.