in the hospital hydration is obviously one of the keys to healing and good health! so i have looked this up in textbooks, but i would appreciate nursing answers on this one...
why is hydration so important for patients while in the hospital?
why are doctors concerned about a patient's fluid intake before discharging them?
i like to know the reasons behind things, it helps me to rememeber better!
thank you for answering my silly but curious question!!
That's interesting to hear that there are better reimbursements if you have an IV running, even at TKO, but not surprising.
We had an issue where I work of MD's ordering IV fluids for everyone, even if it was contraindicated such as with dialysis patients, CHF, Left sided MI, etc. For a while it was just the ED MD's that were doing it (apparently in the ED, IVF cures all). But then when our patients started to be admitted more by hospitalists than cardiologists, we starting seeing the problem continue to the floor as well. It was so common that we stopped even bothering to call to say we weren't going to run the fluids they ordered, we'd just leave a note explaining why it was contraindicated and often write them up as well, but it kept happening.
Our practice council took on the topic and was told by the Hospitalist Director that it was standard practice to order IVF at a rate of 100ml/hr on any patient who was classified as an observation patient since IVF running at 100ml or more an hour would usually change their classification to inpatient, since Medicare uses that as a qualifying factor to be an inpatient. He also explained that they get reimbursed better for everything that they have to do anyway such as the H&P, even a stress test gets a better reimbursement for an inpatient than an observation patient even the they each get the exact same test.
We got a policy put into effect that says they have to include an indication when ordering IVF which has helped some, although many still just order it without an indication and it gets D/C'd automatically.
Interesting. I actually think that (the admin aspects) is probably as interesting, if not more so, than pathophysiology and pharmacology which are why I'm in the field.
One of my former instructors told us this story: She was with a student taking care of a CHF patient admitted for pneumonia. The patient needed some oral suctioning but the Yankauer didn't get much. The instructor told the student to keep working on it and left. The student remembered the fluids lecture and thought "increased fluids will help motility in clearing the airway" and increased the IV rate (patient was NPO for whatever reason). When the instructor came back an hour later, the patient was foaming pink froth at the mouth (but suctioning quite easily as the student pointed out). The instructor about had a heart attack. :eek:Moral of the story: hydration is good, as MunoRN pointed out but each patient has their specific needs.[/quote
True! Critical thinking to the rescue. This truly separates the novice from the experts. It will take time but it can be learned. I struggled in school and now I truly understand when nurses would say to have a balance between big picture thinking vs task oriented thinking
ImThatGuy, BSN, RN
2,139 Posts
Interesting. I actually think that (the admin aspects) is probably as interesting, if not more so, than pathophysiology and pharmacology which are why I'm in the field.