Hydration risk assessment and fluid balance monitoring in older patients at a community hospital

Background: Adequate hydration and fluid balance are essential for maintaining vital metabolic processes. Accurate fluid balance monitoring is therefore a fundamental component of effective patient care. However, monitoring is often compromised by staff shortages, high workloads, time pressures, and limited training, reducing the time available for ensuring accurate documentation. In addition, poor awareness of its clinical significance, unclear roles and responsibilities, and workplace cultures that do not prioritise accurate recording may contribute to inconsistent practice and poor compliance. Aims: This quality improvement project aimed to improve the identification of patients requiring monitoring and increase the accuracy and completeness of fluid balance charts by 50% within 3 months. Method: Using the Model for Improvement Framework, four Plan-Do-Study-Act (PDSA) cycles were conducted. Interventions included targeted staff training, a simplified fluid balance chart, and amendments to the hydration risk assessment. Data were collected through questionnaires and documentation audits. Results: The project led to 100% of the fluid balance charts meeting predefined standards, improved compliance with hydration care plans, and reduced inappropriate fluid balance chart use. Conclusion: Targeted, sustainable interventions can improve fluid balance monitoring, enhance documentation accuracy, and support safer patient care in a community hospital setting. Keywords: Documentation; Fluid balance; Hydration; Monitoring.

Citation

Russell et al (2026). Hydration risk assessment and fluid balance monitoring in older patients at a community hospital. British journal of nursing (Mark Allen Publishing), 35(13), S14–S20. https://doi.org/10.12968/bjon.2025.0594

DOI

10.12968/bjon.2025.0594

URI

https://hdl.handle.net/20.500.14709/1541