Date of Award

Summer 2023

Project Type

Thesis

Department

Nursing

First Advisor

Kaitlynn Liset

Abstract

Background

This paper explores suggested ways to increase intake and output (I&O) monitoring accuracy on a medical-surgical telemetry unit. I&O is a crucial marker for many patients to examine their hydration status and intervention efficacy. Various articles were explored to see best practices and varied in setting and outcomes.

Local Problem

A medical-surgical telemetry unit was analyzed and found to have miscommunication in their ability to monitor I&O for patients' ordered fluid restrictions accurately. Patients may be ordered fluid limits for various reasons; however, the most frequent indication on this unit is for heart failure patients.

Methods


A medical-surgical telemetry unit with eighteen beds was the spotlight for this quality improvement project. The project lead used pre- and post-intervention data collection and PDSA cycle approaches. Pre- and post-intervention surveys were used to assess the efficacy of intervention.

Interventions

A new I&O cluster sheet was placed on the unit to streamline workflows. This sheet was designed to increase compliance with I&O monitoring and documentation.

Results

Over the course of four weeks of collecting results, two PDSA cycles were completed. In the first cycle, no patients with fluid restrictions were admitted to the floor. In the second PDSA 4 cycle, all patients were monitored for I&O. No significant differences were observed before and after the intervention.

Conclusions

More examining needs to be done, and a longer time to collect data to make a firm conclusion on this workflow.

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