Fluid balance chart: do we understand it?
Abstract
Introduction
The fluid balance chart is used as a non-invasive tool to assess the surgical patient's hydration status. Surgical trainees prescribe fluids on a daily basis, an essential part of patient fluid management. A good understanding of these charts is important, as inaccurate interpretation can have a detrimental effect on patient outcome. Therefore, we asked the question: can surgical trainees interpret and calculate fluid balance charts correctly?
Method
We prospectively asked 25 surgical trainees including 12 at Specialty Training (ST) level and 13 at Foundation Year (FY) level, to calculate the total input and output of 13 fluid balance charts, and rate how difficult these charts were to interpret.
Results
Clinical experience does not appear to influence the correct calculation of the total input and output values of the fluid balance charts. However, out of the 13 charts, there is a statistically significant difference from the original documented values in eight of the ST group and nine of the FY group for the total input values, and three of the ST group and four of the FY group for the total output values, with some by a large magnitude.
Conclusion
This study shows alarming results with cause for concern where there is a huge variation in surgical trainee calculated and original documented values, as well as variations between trainees irrespective of training grades, which is a potential risk management issue. It highlights that inaccurate interpretation of these charts are not due to lack of clinical experience, but the fundamental problem lies within the lack of education and inconsistent poor documentation of these charts.
Get full access to this article
View all access and purchase options for this article.
References
1. Daffurn K, Hillman KM, Bauman A, Lum M, Crispin C, Ince L. Fluid balance charts: do they measure up? Br J Nurs 1994; 3: 816–20
2. Levy MF, Greene L, Ramsay MA, et al. Readmission to the intensive care unit after liver transplantation. Crit Care Med 2001; 29: 18–24
3. Lobo DN, Dube MG, Neal KR, Simpson J, Rowlands BJ, Allison SP. Problems with solutions: drowning in the brine of an inadequate knowledge base. Clin Nutr 2001; 20: 125–30
4. Lobo DN. Fluid, electrolytes and nutrition: physiological and clinical aspects. Proc Nutr Soc 2004; 63: 453–66
Cite article
Cite article
Cite article
OR
Download to reference manager
If you have citation software installed, you can download article citation data to the citation manager of your choice
Information, rights and permissions
Information
Published In
Article first published online: January 11, 2010
Issue published: January 2010
History
Issue published: January 2010
Published online: January 11, 2010
Authors
Metrics and citations
Metrics
Journals metrics
This article was published in Journal of Patient Safety and Risk Management.
VIEW ALL JOURNAL METRICSArticle usage*
Total views and downloads: 1213
*Article usage tracking started in December 2016
Articles citing this one
Web of Science: 0
Crossref: 7
- Introducing NICE guidelines for intravenous fluid therapy into a distr...
- Improving the accuracy of fluid intake charting through patient involv...
- Prevention of dehydration in hospital patients
- Learning to prescribe intravenous fluids: A scoping review
- Nurses' Perception and Practice of Fluid Intake and Output Measurement
- The ins and outs of fluid balance in the acutely ill patient
- HEAL: a strategy for advanced practitioner assessment of reduced urine...
Figures and tables
Figures & Media
Tables
View Options
Get access
Access options
If you have access to journal content via a personal subscription, university, library, employer or society, select from the options below:
loading institutional access options
Alternatively, view purchase options below:
Purchase 24 hour online access to view and download content.
Access journal content via a DeepDyve subscription or find out more about this option.
