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How can nurses improve fluid management and reduce the risk of dehydration?

  • Comments (18)

Key points

  • All patients should be assessed for their fluid needs
  • A plan should be made to ensure optimum hydration
  • Fluid intake should be managed continuously
  • Hydration should be reviewed for early detection of deterioration
  • Education for all involved and effective communication throughout underpin the principles of successful fluid management

Let’s discuss

  • Think about your ward or unit. How do you monitor the accuracy of fluid balance charts?
  • What strategies could you use to ensure patients receive adequate fluids?
  • Why do you think dehydration is a problem in hospitals?
  • What strategies have your Trust developed to improve monitoring and management of patients who are at risk of dehydration?
  • How could the Intelligent Fluid Management Bundle described in this article help reduce the problem of dehydration in hospitals?
  • Comments (18)

Readers' comments (18)

  • Anonymous

    Maybe an extra member of staff per shift whose only role is to ensure at risk patients are given drinks and maintain fluid charts.

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  • Anonymous

    Maybe graft on a couple of sets of arms, that stretch around corners. That way I could feed at risk patients, while toileting another, and keeping the charts up to date.

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  • Anonymous

    How about nurses and assistants think about their patients and how they must be feeling. We all know how horrid it is to have a dry mouth. It doesn't take much to pour out a drink or make a cup of tea.

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  • Anonymous

    Compulsory 3 hourly drink rounds. Staff made available to help those who cannot lift a drink off the table or who need thickener mixing into their drink. Despite being a post P2000 nurse, I can see the benefit of the "traditional" way of nursing in the hospital - set times for "routine/fundamental" task. The whole set of the hospital only lends itself to this type of nursing.

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  • Anonymous

    won't giving drinks be included in Mr Cameron's rounding scheme?

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  • Anonymous

    there is much to be said for task orientated nursing, there is a lot of opposition to it when people wanted individualised patient centred care but it worked. Patients who are perceived to be 'independent' can get overlooked.

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  • Anonymous

    I think common sense and discretion will be required for 'independent' patients. some may welcome the extra attention whereas others could find it very irritating that their personal preferences and responsibility are being questioned and may feel they are being patronised and treated like a child. In some cases this can lead to anger and aggression.

    Just generally chatting to the patient and good old fashioned observation should help give tell tale signs if anything is wrong or if the patient is becoming dehydrated or malnourished during their hospitalisation.

    Depressed mood and debilitation can remove their incentive to take adequate fluids and food and this can set up a vicious circle but any nurse or other individual on the ward should be able to detect this and offer assistance or report it to the trained staff.
    For this group of patients it should be made sure they have at their disposal sufficient to meet all of their nutritional and hydration needs.

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  • reduce the necessary paper work and give us the time to cater for those we are suppose to serve the needy patient not creating rotas, filling agency worker time sheets or the delivery man invoice notes and collecting the pharmacy plus mar charts of which i think can be done by the manager who sits and has all the time in her office

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  • Anonymous

    It should not be difficult to identify those patients who require assistance or encouragement to drink/eat. Many of these people will be elderly and may be suffering the effects of dementia.

    Developing a care plan to meet these patients needs, similarly should not be difficult.

    Implementing the care plan on an acute ward may pose difficulties i the face staff shortages or lack of patient co-operation.

    In the case of staffing deficiency a report Must be made on every occasion nurses are unable to full-fill their patients identified needs.

    If a lack of patient co-operation prevents nurses full-filling the patients needs this must be documented on each occasion such a lack of co-operation is experienced.

    In the case of patients suffering dementia it can sometimes be of assistance to encourage someone who knows the paient well to assist with feeding and hydration.

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  • Anonymous

    do you really need a care plan to give a patient and fellow human being a drink? perhaps you need to spend time making a nursing diagnosis as well and even confirm it with a medical diagnosis? During the time spent on this taxing mental exercise several patients could have been given drinks - but obviously too busy, not time!

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