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Improvement of fluid balance monitoring through education and rationalisation.

ABSTRACT: Fluid input/output charts in hospital inpatients are a valuable source of information for doctors reviewing intravenous fluid prescription, but are notorious for being incomplete and inaccurate. Lack of awareness of the importance of fluid balance amongst nursing staff and an excess of unnecessary monitoring are two factors contributing to the problem. We conducted a quality improvement project on the respiratory ward in a large district general hospital aiming to specifically address these two factors. Pre-intervention audit showed that only 53% of input/output monitoring was clinically indicated, with an average chart completion of 50%. Using e-Learning and verbal presentation to raise awareness around fluid balance, we implemented a new system whereby daily medical review of charts lead to rationalisation of monitoring. Post-intervention audit showed a 93% reduction in unnecessary monitoring, with corresponding increases in completion (40%) and accuracy (48%) of remaining charts. In conclusion, education has enabled a culture change on the ward that has drastically increased the quality of fluid balance monitoring.

SUBMITTER: Vincent M

PROVIDER: S-EPMC4752718 | biostudies-literature | 2015

REPOSITORIES: biostudies-literature

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Improvement of fluid balance monitoring through education and rationalisation.

Vincent Masaki M Mahendiran Thabo T

BMJ quality improvement reports 20151209 1

Fluid input/output charts in hospital inpatients are a valuable source of information for doctors reviewing intravenous fluid prescription, but are notorious for being incomplete and inaccurate. Lack of awareness of the importance of fluid balance amongst nursing staff and an excess of unnecessary monitoring are two factors contributing to the problem. We conducted a quality improvement project on the respiratory ward in a large district general hospital aiming to specifically address these two ...[more]

PMID: 26893885

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Project description:BackgroundWith the remarkable attention being paid to STEM education nationally, with the growing engagement of universities and colleges in STEM education reform, and with the rise of STEM education centers, SECs, assisting universities as they strive to achieve these reforms, this research provides insight into the roles of six SECs. Through a multi-dimensional cross-site comparison, we provide a lens into the ways in which SECs function on their campuses, illuminating possibilities for those seeking to strengthen undergraduate STEM education.ResultsSECs play an important networking role on their campuses, where they inform and unify institutional efforts, serving to elevate their visibility and importance both internally and externally. Through their scholarship, SECs contribute to the knowledge base and provide funding, which add resources and incentives for the implementation of evidence-based instructional practices (EBIPs) and STEM education research. SECs augment these efforts with the assessment and evaluation of learning outcomes and curricular innovations. Additionally, SECs act as an internal resource for faculty and instructors providing programs and training to foster the application of EBIPs in STEM courses. Several SECs provide the infrastructure for broader impact activities, and act as an external funding resource.ConclusionsSTEM education centers make key contributions to their institutional environments. While the individual roles of these SECs on their campuses are distinctly unique, an in-depth look across six SECs reveals common areas of focus that allow these centers to enhance the undergraduate teaching and learning experience. Our results suggest that the ability of SECs to link STEM education research with teaching and learning initiatives provides a breadth of impact and attention across organizational levels. The analysis describes the ways in which these centers support institutional goals for undergraduate STEM education and relates these to areas of national priority. This research was carried out as part of a broader study, which informs the organizers of NSEC, the network of STEM education centers.

Dataset Information

Improvement of fluid balance monitoring through education and rationalisation.

Publications

Improvement of fluid balance monitoring through education and rationalisation.

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