Investigating the recording and accuracy of fluid balance monitoring in critically ill patients

摘要

BACKGROUND: The accurate assessment of fluid balance data collected during physical assessment as well as during monitoring and record-keeping forms an essential part of the baseline patient information that guides medical and nursing interventions aimed at achieving physiological stability in patients. An informal audit of 24-hour fluid balance records in a local intensive care unit (ICU) showed that seven out of ten fluid balance calculations were incorrect. OBJECTIVE: To identify and describe current clinical nursing practice in fluid balance monitoring and measurement accuracy in ICUs, conducted as part of a broader study in partial fulfilment of a Master of Nursing degree. METHODS: A quantitative approach utilising a descriptive, exploratory study design was applied. An audit of 103 ICU records was conducted to establish the current practices and accuracy in recording of fluid balance monitoring. Data were collected using a purpose-designed tool based on relevant literature and practice experience. RESULTS: Of the original recorded fluid balance calculations, 79% deviated by more than 50 mL from the audited calculations. Further more, a significant relationship was shown between inaccurate fluid balance calculation and administration of diuretics (p=0.01). CONCLUSION: The majority of fluid balance records were incorrectly calculated.