Pre‐procedure

ActionRationale

1. 1.Show
   Introduce yourself to the patient, explain and discuss the procedure with them, and gain their consent to proceed.
   To ensure that the patient feels at ease, understands the procedure and gives their valid consent (NMC [126], C).
2. 2.Show
   Determine the relevant sources of fluid output (see Table 8.3) and note them on the fluid balance chart.
   To ensure all possibilities have been considered to ensure accurate (as far as possible) output determination (McGloin [98], E; Scales and Pilsworth [158], E).

Procedure

1. 3.Show
   Explain to the patient that it is necessary to measure their urine output.
   To ensure that the patient knows that any urine they pass needs to be measured in order to record output and to obtain their co‐operation in ensuring accuracy of measurement (Georgiades [59], E).
2. 4.Show
   Provide the patient with bedpans or a commode, even if able to mobilize to the bathroom; ask them to place the bedpan over the toilet bowl; ask them to inform you of each episode.
   To ensure the urine is kept for measuring and not disposed of (Georgiades [59], E).
3. 5.Show
   Use personal protective equipment required for body fluids when handling used bottles or bedpans.
   To prevent cross‐infection ([115], C).
4. 6.Show
   Place bedpan or bottle onto the scales, subtracting the appropriate value to compensate for the weight of the item.
   To obtain the amount of urine in grams, which equates to the same in millilitres. E
5. 7.Show
   If no scales are available, use a jug with volume markings; pour the urine into a jug (using standard precautions), noting the level of urine.
   To measure urine volume. E
6. 8.Show
   Once noted, dispose of urine appropriately.
   To prevent contamination and/or cross‐infection (Loveday et al. [91], R).
7. 9.Show
   Record the value on the fluid balance chart, adding this to the rest of the output values for the hour.
   To determine fluid output for the hour (McGloin [98], E).

Post‐procedure

1. 10.Show
   Once all output has been determined and noted on the chart, calculate the total hourly output and then subtract the total output from the total input.
   To calculate hourly fluid balance. E
2. 11.Show
   Document all values on the chart and record any other actions relating to your findings in the patient's notes.
   To ensure accurate documentation (NMC [126], C).