Problems with I+O's help!

[NYCRN6]

So i am very anal with my I+O's. One day when i actually had 15 minutes to spare... i went through the entire census of our floor @ about 9pm (during a 3-1130p shift) and found that over 50% of the people were not documented on I+O's from last shift to 15 hours before. Yes i did take into consideration the admissions so i did not count them. However out of these people that weren't documented on 1 of them was

SO in essence... me and another coworker are putting together ideas for our nurse educator so we can make our I+O's better documented:

*somehow enhance communication between RN's and PCA's to prevent double documentation or no documentation

* signs on walls for strict I+O's (which i already do but not most people do)

* If pt is strict I+O in addition to dietary doing the calorie count they can do this also before the tray is taken away.

* Deem 1 leader PCA each shift to help reiiterate this issue (but just in general everyone reiiterate with their given PCA's with each patient)

Any other ideas????? Please let me know i need ideas by saturday!

[suanna]

Common. It's no wonder we get orders written like "strict I&O and RECORD" or "Accurate I&O daily please". The docs might as well write "nurses do your job while caring for this patient please"

[Virgo_RN, BSN, RN]

Where I'm doing my clinical, I&Os are recorded on a sheet by anyone who empties a urinal, brings the patient juice, refills the water pitcher, etc. At the end of the shift, the nurses go and collect the sheets and do the recording. The system seems to work well.

On the floor on which I work, the I&Os are written on a white board. Anyone who empties a urinal, refills a water pitcher, collects a meal tray, etc. is supposed to record the I&O on the white board. At the end of the shift, when the CNA does last rounds, they are supposed to do the tallies and record them in the chart.

From my observation, the former method seems to result in more accurate I&Os.