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 it is necessary to monitor drainage every hour.
   To inform the patient of their current care and interventions (Liaw and Goh [86], R).
2. 5.Show
   Ensure the gastric outlet device has a drainage bag attached.
   To collect any output for measurement. E
3. 6.Show
   If instructed, leave the bag open to drain (this may differ depending on the patient's condition).
   To enable drainage. E
4. 7.Show
   Drain contents into marked jug every hour (if quantity allows), using standard precautions.
   To determine volume. E
5. 8.Show
   Attach a urometer if output is high.
   To ensure accurate reading and for ease of measuring. E
6. 9.Show
   Note volume on fluid balance chart, adding this value to the rest of the output values for that hour.
   To enable determination of fluid balance (McGloin [98], E; Sumnall [176], 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 (McGloin [98], 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).