The importance of recording fluid intake and output

Recording fluid intake & output is an important clinical care process that helps the caregivers to determine the progress of the disease & the effects of the treatment. Recording of intake helps to ensure that the patient has a proper intake of fluid and recording of output helps to determine whether there is an adequate output of urine & normal defecation. Correct recording of fluid balance charts allows nurses to recognise trends that indicate a patient may be heading in a downward spiral, therefore tin order to promote adequate hydration, and safe and effective nursing care; nurses and hcas should always report any significant abnormalities identified in patients’ fluid record.

The Intake-Output Chart

The intake-output chart is used for the purpose of documenting & sharing information regarding;

• Whatever fluid is taken by the patient (either via the gastrointestinal tract or through the intravenous route)
• Whatever is excreted/removed from the patient

This is also called the fluid balance chart.

Who is responsible to record fluid intake & output

It is the responsibility of nurses and healthcare assistants to record fluid intake and output.

Responsibilities of Nurses

• To identify patients who need fluid balance monitoring & communicate via whiteboard behind bed, handover
• To Clarify up-to-date plan with the medical team and communicate to patient and visitors, wider MDT including HCAs: SALT, housekeeping, physio, and any colleague who may assist with, provide or remove fluids
• Ensure accuracy using charts and calculating cumulative measurements 6 hourly
• Escalate promptly to the medical team in case of developing imbalance, deterioration or concern

Responsibilities of HCAs

• Teamwork, Communicating with MDT to ensure accurate measurements
• Ensure chart is complete and accurate – use of appropriate equipment e.g. scales, urometers etc
• Inform trained staff or NIC with changes deterioration, or concerns

Please check more details on the fluid balance monitoring

Importance

The intake-output chart provides below ideas about the patient

• Gastro-intestinal functions such as ability of the patient to eat/drink, absorb food & defecate
• Fluid balance & the renal function (ability to pass urine in adequate amounts)
• Occurrence of any abnormal losses
• Bowel movement