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Fluid balance chart: do we understand it?

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...

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Published in:Clinical Risk Vol. 16; no. 1; pp. 10 - 14
Main Authors: Tang VCY, Lee EWY
Format: research tables/charts Journal Article
Published: Sage Publications, Ltd. Jan2010
Online Access:View this record in EBSCOhost
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      pub: Sage Publications, Ltd.
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        10.1258/cr.2009.090005
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        atl: Fluid balance chart: do we understand it?
      aug:
        au:
          Tang VCY
          Lee EWY
        affil: Espom and St Helier University Hospitals NHS Trust, Surrey, UK; vincetang@hotmail.com
      sug:
        subj:
          Data Analysis
          Fluid-Electrolyte Balance
          Interns and Residents
          Patient Care
          Surgeons
          Data Analysis Software
          Human
          Mann-Whitney U Test
          United Kingdom
          Wilcoxon Rank Sum Test
      ab: 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.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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