Abstract
Intravenous diuretics remain the mainstay of treatment for patients admitted with decompensated/acute heart failure. NICE recommends close monitoring of the renal function, body weight and urine output during diuretic therapy as part of the initial pharmacological treatment of acute heart failure. The aim is to ensure a safe and satisfactory response to treatment.
We looked at the compliance to serial measurement of Body Weight and Fluid Balance in the geriatric population admitted with Decompensated/Acute Heart Failure to Acute Care Units at Kettering General Hospital. Fifty (50) patients, 65 years or above, admitted with decompensated/acute heart failure were randomly selected from MAU and Clifford ward (Acute Care Units).
Acutely unwell patients or those with urgent care stay duration less than 24 hours were excluded. Patients who had other causes of fluid overload were also excluded.
By the end of the 1st cycle, only 28% of the patients had weight measured daily, whilst only 18% had accurate fluid balance charting done. Barriers leading to poor compliance in measurement of these parameters were identified. Nursing managers were involved and audit results were shared with the clinical staff. Written reminders to check and record daily weight and fluid balance were put around the acute care units.
We liaised with the Trust’s digital team to assist with introducing these measures on the Trust’s software called ‘CareFlow Vitals’ as these were ‘vital’ parameters for a patient with acute heart failure. This eventually improved our results with almost 100% compliance by the end of our 3rd cycle.