Liverpool Royal Nurses Talk Fluid Balance
We caught up with Liverpool Royal’s Acute Kidney Injury nurses, Katie Rimmer Algate, Natalie Erickson, Jenni Soddern and Marie McCarthy, and asked them about the importance of accurate fluid balance management.
Tell us about the current fluid balance system
Currently we use paper charts for fluid balance monitoring. This means that staff have to ask the patients what they have had to drink, and relies on the patient remembering what they have had to drink.
For those unable to report to staff what they have consumed, the system relies on staff being around when drinks are collected, which is not always possible. Intravenous fluid recording can vary and output monitoring can prove difficult, particularly if the patient is mobile. These, amongst other issues leads to discrepancies in the accuracy of fluid balance charts.
How important is it for the patient’s welfare to get accurate data?
Fluid balance plays a very important part in the patient assessment. It can influence treatment choices and decisions. It can also indicate when a patient’s condition is deteriorating. The accuracy of these charts is vital when you are making decisions about a patient’s treatment or assessing them if they are clinically unstable.
… and for Acute Kidney Injury patients?
When assessing a patient with AKI, fluid balance is one of the most important tools to base treatment decisions on. Does this patient need more or less fluid? What is their urine output? These are all key aspects in the treatment of AKI.
What are you currently doing to improve the system?
We currently provide education for HCA’s on fluid balance and have an AKI e-learning module for both nurses and HCA’s to complete. We are part of the nutritional CPD where we focus on fluid balance and provide ward-based fluid balance teaching where requested.
How could a digital fluid balance system such as Aquarate help?
The accuracy of the fluid balance charts are currently only as good as the person filling them in. External influences such as time constraints, busyness and staffing levels can all contribute to the accuracy, or otherwise, of the fluid balance charts currently in use. To have a digital system in place may help to improve the accuracy and eliminate some of the factors effecting the current process of manual completion.
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