Fluid Balance Monitoring Accuracy in Intensive Care Units

Abstract

Introduction: Fluid balance monitoring is a part of the scope of nurses' practice. The incorrect calculation of fluid balance means that every patient management decision was influenced by inaccurate fluid balance information. Therefore, nurses working in ICUs are responsible and accountable for the accurate recording and calculation of fluid balance when caring for critically ill patients. The aim of the work to examine the accuracy of fluid balance monitoring in critical care units and determine the factors affecting fluid balance monitoring in critical care units. The study design was a descriptive research design. Setting, This study was carried out in two general intensive care units (ICUs) at a selected Hospital in Alexandria-Egypt. Subjects, fluid balance related records for 100 critical care patient and 60 critical care nurses was drawn from the previously mentioned ICUs. Data collection instrument; the tool of this study was "Fluid balance monitoring accuracy in ICUs" This tool combined two parts: "Fluid balance monitoring audit" and "Fluid balance monitoring questionnaire". Results; 65% of fluid balance recorded in patients' folders were accurate and 35% were inaccurate. The level of nurses' knowledge regarding fluid balance monitoring in ICUs was moderately adequate (61.67%) and 71% of nurses had favorable perception regarding fluid balance monitoring in ICUs Inaccuracy of the measuring equipment / continuous intravenous infusions, time management (100%), workload (91.67%) and lack of skills/ training (33.33%) were factors affecting fluid balance monitoring as reported by nurses. Conclusion: Two thirds of the recorded fluid balance was accurate and the inaccurate fluid balance recorded was fluctuating between positive and negative balance. Nurses reported that inaccuracy of the measuring equipment / continuous intravenous infusions, time management, workload, and lack of skills/ training are factors affecting fluid balance monitoring in ICU. Recommendations: For accuracy of fluid balance monitoring in ICU, increase awareness and in-service education should be conducted to improve nurses' knowledge. Novice nurses should be trained adequately regarding assessment and monitoring of fluid balance.