Policy Manual sample

MDT Home Health Care Agency, Inc. 65 INTAKE AND OUTPUT RESPONSIBLE PERSONNEL: RN, LPN, HHA, Caregiver and/or Patient EQUIPMENT: Paper to record intake/output, pen or pencil PROCEDURE: 1. Explain and teach procedure for fluid intake and output to patient/caregiver. 2. Measure patient's fluid intake as follows: a) Record fluid intake at each meal and between meals. b) Record Jell-O and ice cream as fluid intake. 3. Measure fluid output as follows: a) Measure all urine, emesis and loose stools. b) Estimate incontinence amount. c) Use graduated pitchers for measuring client liquid output. 4. Record patient fluid intake and output on fluid Intake and Output Record form. 5. Total fluid intake and output for 24 hour periods. DOCUMENTATION: Document fluid intake and output in totals on Intake and Output Record along with observations, assessments and interventions in the patient's clinical record. Document teaching activities with patient/caregiver and their level of understanding. The nurse should monitor information provided by the patient or caregiver regarding the intake and output and record in the clinical visit note. Results should be communicated to the patient’s physician and any new orders reflected in the clinical record. ____________________________________________________