I&O policy

Iworecords, RN · Dec 23, 2009

How do you plan to measure the output of an incontinent resident without using a foley? Measuring the output of an alert and oriented resident who is continent is easy enough -- but throw in confusion on top of the incontinence and your staff will be pulling out their hair. As a regional DON I once visited a facility that had their staff place the wet briefs on a scale -- but in reality that was not accurate if they were also soiled with feces that was not easily removed. Even the state questioned this method. And what will you do with a heavy wetter who leaks thru the briefs and gets clothing or bedding wet?

Some times we attempt to be too complicated. There are times strict I&O is called for -- but other times when it is beyond what is needed. And how many times have we shot ourselves in the foot trying to do the impossible?

morte, LPN, LVN · Dec 23, 2009

How do you plan to measure the output of an incontinent resident without using a foley? Measuring the output of an alert and oriented resident who is continent is easy enough -- but throw in confusion on top of the incontinence and your staff will be pulling out their hair. As a regional DON I once visited a facility that had their staff place the wet briefs on a scale -- but in reality that was not accurate if they were also soiled with feces that was not easily removed. Even the state questioned this method. And what will you do with a heavy wetter who leaks thru the briefs and gets clothing or bedding wet?
Some times we attempt to be too complicated. There are times strict I&O is called for -- but other times when it is beyond what is needed. And how many times have we shot ourselves in the foot trying to do the impossible?

oy, if i had a nickel for every time i tried to explain that concept to someone doing an over the top care plan!

i think the only time an I+O on a patient on ABT would be logical would be with sulfa based drugs.

CapeCodMermaid, RN · Dec 23, 2009

If they are incontinent obviously we're NOT going to use a foley just for I&O. We do the best we can. If the policy says measure urine of a CONTINENT resident....we're okay. It's very simple. ONLY do I&O if you really really need to.

sasha2lady · Dec 24, 2009

well.....we used to do I & Os on pts with a foley, ....now they tell us not to...that we have to DOCUMENT the amount on a nurses note......the corporate nurse told us that we should only do I/O for someone who has vomiting and diarrhea???? Im not quite understanding that one....and also...whats the deal with a sulfa antibiotic? Why would you need to do I/O for that? Just wondering since Ive never even heard that be mentioned before. And as for incontinent ones....we have always put x2 or what applied....if its ina brief...good luck with that one.

morte, LPN, LVN · Dec 24, 2009

well.....we used to do I & Os on pts with a foley, ....now they tell us not to...that we have to DOCUMENT the amount on a nurses note......the corporate nurse told us that we should only do I/O for someone who has vomiting and diarrhea???? Im not quite understanding that one....and also...whats the deal with a sulfa antibiotic? Why would you need to do I/O for that? Just wondering since Ive never even heard that be mentioned before. And as for incontinent ones....we have always put x2 or what applied....if its ina brief...good luck with that one.

my understanding is that sulfa+inadequate fluid intake= kidney damage, so you would want to document adequate intake.