Usefulness of the fluid balance: A randomised controlled trial in neonates

Bekhof, Jolita; Asperen, Yvette van; Brand, Paul

doi:10.1111/jpc.12214

Cited by 3 publications

(1 citation statement)

References 14 publications

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“…This has changed the way we treat common paediatric conditions. For example, we no longer routinely perform fluid balances in newborns,20 stopped applying cohort isolation and viral diagnostic tests in bronchiolitis21 and were able to reduce venipunctures in jaundiced newborns by >30% after introduction of transcutaneous bilirubinometry 22…”

Section: Results Of the Ebm Projectmentioning

confidence: 99%

Implementing evidence-based medicine in a busy general hospital department: results and critical success factors

Draaisma

Bekhof

Langenhorst

et al. 2018

BMJ EBM

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Implementing evidence-based medicine (EBM) in a busy hospital department is challenging, but when successful, may contribute to quality of care. This paper is a narrative review of the successes and challenges of deliberate implementation of EBM in a paediatric department in a general teaching hospital in Zwolle, the Netherlands. Key elements in this project were providing basic EBM education to the entire team of consultants and nurse practitioners, structurally embedding EBM activities into our weekly schedule and development of local practice guidelines. This deliberate practice of EBM principles has changed the way we treat common paediatric problems. It likely reduced unwarranted practice variation and promoted a reserved attitude towards the use of unnecessary diagnostics, which might improve delivery of effective, cost-conscious care. The project also positively influenced our group culture and learning environment. In accordance with previous reports, lack of time and reluctance to change routines and habits hindered the practice of EBM in our department. In our experience, these barriers can be overcome by promoting a team-wide endorsement of EBM, a willingness to acknowledge uncertainty and by deliberate practice. If these can be achieved, systematic application of EBM principles in a busy hospital department is feasible and worthwhile.

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Section: Results Of the Ebm Projectmentioning

confidence: 99%

Implementing evidence-based medicine in a busy general hospital department: results and critical success factors

Draaisma

Bekhof

Langenhorst

et al. 2018

BMJ EBM

Self Cite

View full text Add to dashboard Cite

show abstract

Urine Specific Gravity Measurement for Fluid Balance in Neonates on Intravenous Fluids in a Neonatal Intensive Care Unit: An Open Label Randomized Controlled Trial

Jha

Tewari

et al. 2022

Indian Pediatr

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Fluid balance monitoring in congestive heart failure patients in hospital: a best practice implementation project

Yang¹,

Mu²,

Wu³

et al. 2019

JBI Database of Systematic Reviews and Implementation Reports

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Objectives: This aim of this project was to promote best practice in fluid balance monitoring in congestive heart failure patients. Introduction: Fluid overload or pulmonary/vascular congestion is a common clinical feature in patients with heart failure and is associated with adverse outcomes. Maintaining records of patients’ fluid intake and output (I&O) has long been considered an important aspect of nursing care to assess hydration status. In clinical practice, a prevalence of incongruence between I&O results and clinical signs and symptoms has been noted. We postulate that this incongruence may be due to an inaccurate or non-comprehensive collection of fluid I&O and/or patients’ and their families’ inadequate recognition of the importance of I&O recording. Methods: This implementation project was conducted in a cardiology ward of a medical hospital using the JBI Practical Application of Clinical Evidence System. Three audit criteria were utilized to represent best practice recommendations for fluid balance monitoring. A pre-implementation audit was conducted, followed by development of multiple interventions identified from a Getting Research into Practice analysis. Two post-implementation audits were conducted to determine the change in practice. Results: The post-implementation audit data demonstrated significantly improved outcomes across the measured best practice criteria. Specifically, improvement in compliance was noted in: i) fluid balance charts being utilized in conjunction with physical assessment and electrolyte monitoring to assess the hydration status of a patient (from 58% to 100% compliance); ii) patient involvement in more accurate documentation (from 42% to 75% compliance); and iii) staff education in fluid balance monitoring and documentation (from 53% to 100% compliance). Conclusion: Fluid record omission was reduced at the completion of the project secondary to an increased awareness of the fluid record omission standards among patients as well as physical assessment and fluid overload correlation among the nursing staff in the unit. The findings demonstrate how audits can be utilized to promote best practice in health care. Additionally, the data indicate that focused education and the provision of relevant resources can have an immediate and positive impact on clinical practice.

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Usefulness of the fluid balance: A randomised controlled trial in neonates

Abstract: Routinely keeping fluid balances in neonates with moderate disease severity does not affect duration of hospitalisation or medical treatment.

Cited by 3 publications

References 14 publications

Implementing evidence-based medicine in a busy general hospital department: results and critical success factors

Implementing evidence-based medicine in a busy general hospital department: results and critical success factors

Urine Specific Gravity Measurement for Fluid Balance in Neonates on Intravenous Fluids in a Neonatal Intensive Care Unit: An Open Label Randomized Controlled Trial

Fluid balance monitoring in congestive heart failure patients in hospital: a best practice implementation project

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