I and O's

ClearBlueOctoberSky · Oct 23, 2012

We don't do that. The aides will chart intake at meals, and the only time we are charting output is if they have a foley.

morte, LPN, LVN · Oct 23, 2012

I thought it was part of med A assessment. The I+O with ABT may have started with sulafa AB. You can get Kidney issues if not enough liquid is taken in. I know of one place were all patients are on I+O. You get some pretty funky imbalances (on paper) among the ambulatory patients.

CapeCodMermaid, RN · Oct 23, 2012

If the patient doesn't have hydration issues, I and O doesn't have to be part of a Medicare assessment. I'll be speaking to the medical director about it this week.

NotFlo · Oct 23, 2012

Am I the only one that finds that in LTC/rehab "strict" I and O is a joke anyway? Getting anything resembling an accurate I and O seems impossible. I know the CNAs basically make up what they put into the care tracker, you have 2 people sharing a bathroom and if they are ambulatory they forget about the hat, forget to get someone to measure and flush, pee in each other's hat, etc. It's a mess. I have over 20 pts, impossible for me to collect all the intake myself for every meal.

We have a doc who orders "strict" I an O for people constantly, of course she doesn't want them to have a foley, then she gets ****** if the "voided x 2 this shift" is entered on the I and O, but sometimes you get there and the hat is gone and they tell you they already peed twice etc.

RanieRN, MSN, RN · Oct 23, 2012

We put new admissions on a 72 hour bowel and bladder tracking, but never I&O unless there's a reason (foley, IV, fluid restriction, etc). We don't do I&O for abx either.

artsmom, BSN, LPN · Oct 23, 2012

We put new admits on for 72hrs because it is on our admission sheets. I don't think they are needed either, not that they are filled out correctly anyways. We don't put people receiving ABX on I & O. The only ones we document regularly are foley's (output only), and g-tube patients.

VANurse2010 · Oct 24, 2012

Yes, strict I&O in a LTC setting is ridiculous - if for no other reason than there's about a 0% chance it will be accurate.

Nascar nurse, ASN, RN · Oct 24, 2012

We only do I&O for fluid restriction and foley's. Agreed with many above - ridiculous to think it's ever going to be "strict" I&O.

deleern · Oct 25, 2012

I use the the I&O to track voiding for the care plan. with the new computerized ADL/s it works like a charm.

AngelRN27 · Oct 26, 2012

No I&O at my facility except for output for foleys (and this is simply to know that the foley is working, really). Meal consumption and fluid intake during meals is charted by our CNA's. Other than that, I&O in a LTC setting would pretty much be 0% accurate. Even if we could properly/accurately document I&O in such a setting, I'm not sure how this info would be helpful as I&O in the elderly can be very tricky and does not necessarily point out any pathophysiology as it would in an otherwise healthy adult... incontinence, less need for input, slower metabolism, polypharmacy, and lowered ability to retain fluids via integument would all contribute to an "abnormal" I&O...

amoLucia · Oct 28, 2012

The more and more paperwork that's required of staff just presents more and more opportunity for missed and/or gaps in the required documentation. It's just more chances for surveyors to spot 'faliure to complete in-house charting'. Like waving a red flag for all to observe.