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).
3. 3.Show
   Wash hands and/or use an alcohol‐based handrub and apply personal protective equipment necessary for handling body fluids.
   To appropriately decontaminate hands and prevent cross‐contamination ([115], C).

Procedure

1. 4.Show
   Explain to the patient that the output from the drains will be monitored hourly.
   To inform the patient about their current care and to ensure they are not alarmed by the frequent observations (Liaw and Goh [86], R).
2. 5.Show
   If the drain is drainable, empty the contents into a jug, noting the volume.
   To determine the volume of the fluid drained. E
3. 6.Show
   If it is not possible to drain the fluid out of the bag, use some tape (stuck along the length of the bottle) and/or a suitable pen and mark the level the fluid reaches each hour. Date and time each marking.
   To determine drainage each hour. To ensure consistency in reading and to communicate to other members of the multidisciplinary team regarding drainage (Sumnall [176], E).
4. 7.Show
   Note volume/drainage on fluid balance chart.
   To determine drainage each hour (McGloin [98], E).
5. 8.Show
   Add this figure to the rest of the output values for the hour.
   To accurately determine total fluid lost each hour (McGloin [98], E).

Post‐procedure

1. 9.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 (Davies et al. [44], R).
2. 10.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).