I am currently doing a service improvement project at university, based on improvement of fluid balance charts, regarding monitoring and recording, more specifically for surgical high care patients.
I originally wanted to look at oral input charting as this seems to be the most inaccurately measured, but research returned little to work with - perhaps this was too centralised on one aspect. I am therefore searching more in depth to improvement of monitoring/recording as a whole.
Any help will be greatly appreciated!
Alana - I think that you would need to elaborate. This is a large topic area - and not just a nursing issue. What exactly do you want to monitor/observe/change 'in-depth' and in relation to what? Most hospitals/trusts/boards etc are regularly looking to improve core and standard monitoring procedures and tools.
Hi Dean Whitehead,
Thank you, I absolutely agree - I'm looking at it from a nurse's perspective as part of their workload and improvement of patient care/outcomes, specifically for improvement on how fluid input/output is calculated and recorded on paper records which are currently in place.
What I have seen in practice agrees with research I have found about oral input recording, in that it is poorly documented, so renders the whole document inaccurate and therefore the care that may follow i.e. resuscitation and/or management of fluids.
Research I have found have implementation strategies for improvement, some of which I have seen in practice i.e. visual guides for cup measurements but do not seem to have previously improved documentation. Specifically when including words such as 'sips', 'OTT' (out to toilet) rather than a numeric value.
I would agree that education on the importance of fluid balance recording/documentation is a must for improvement in practice, but trying to find a strategy to implement that has been seen to work in practice, therefore improving patient outcome, is proving difficult.
I don't know how to improve overall monitoring but I have a suggestion for oral intake. If the person is able, empower them to monitor their own oral intake. A simple checkbox form with the type of drink and how much or teaching them how-to record ml's or cc's works well. After all, shouldn't patients have an active role in their care?
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