The ins and outs of fluid balance in the acutely ill patient

Many reports and studies have highlighted concerns with fluid management in acute care settings. The level of knowledge displayed by nurses and the influence this has on fluid management is often analysed. Nurses measure patients' fluid intake and output in the belief that medical staff will use the data to prescribe appropriate fluid management. However, in reality, medical staff often disregard such data as inaccurate, with terms such as 'OTT' (out to toilet) clearly affecting the accuracy of data. Consequently, practitioners require a comprehensive understanding of fluid physiology and the potential risks to the patient when there is inappropriate documentation of fluid status. The use of the fluid balance chart is examined as a means to assess fluid status, and other supplementary assessment strategies are also considered. The aim is to ensure comprehensive assessment and evaluation of an individual's fluid status, thereby guiding appropriate fluid management in the acute care setting.