HEAL: a strategy for advanced practitioner assessment of reduced urine output in hospital inpatients

To produce a model for advanced nurse practitioners (ANPs) to follow in the assessment and management of patients with a reduced or low urine output.

Reduced urine output can be caused by a multitude of factors, some of which signify serious disease or may lead to serious morbidity. Assessment of reduced urine output is essential to ensure that patient safety is maintained at all times. Advanced nurse practitioners can add to patient safety by undertaking assessments of these patients at appropriate times and managing appropriately.

This paper presents a new model for immediate triage, assessment and treatment for reduced urine output, using history, early warning score, accuracy and laboratory results, or HEAL, with clear points for referral where appropriate.

This model can be used by advanced nurse practitioners to guide assessments and ensure that patients are appropriately managed in response, with minimal additional training.

This can aid advanced nurse practitioners in assessment, increasing patient safety and expatiating management. This shows how ANPs can be used to safely blur traditional professional boundaries with the aid of protocols.