Following modification there was a subjective improvement in the quality of chart completion. Introduction of board magnets improved correlation between doctors and nurses in identification of patients (52% before, 77% after magnets). Post education there was a reduced number of inappropriate charts. Of these 0-45% of them were correctly filled. Initial results showed a range of 6-12 charts used daily per ward. Each intervention was implemented for one week followed by daily surveys for four days to monitor compliance. Questionnaires were utilised to highlight improvements with current charts and measured staff awareness pre and post education. Three interventions were deployed on two acute medical awards in consecutive cycles 1) small group education for staff, 2) creation of board magnets to aid the multidisciplinary team to identify patients requiring monitoring, 3) modification of the current fluid balance chart. Three areas for improvement were identified: understanding the importance of good fluid balance monitoring, correct identification of patients requiring monitoring, and ease of completion of fluid balance charts. This project aimed to increase the percentage of fluid balance charts correctly completed on the wards. Clinical experience and nursing metrics have consistently identified poor documentation of fluid balance monitoring at Milton Keynes University Hospital, compromising patient safety and quality of care.
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