Document Type

DNP - Open Access

Award Date


Degree Name

Master of Science (MS)


Graduate Nursing

First Advisor

Robin Arends

Second Advisor

Danielle Schievelbein


fluid status monitoring, cardiac, fluid balance, intake and output, nurse knowledge, attitudes, and practices


Background: Monitoring fluid status may prevent adverse patient outcomes. Nurses and unlicensed staff are responsible for inpatient fluid status monitoring and documentation.
Methods: Registered nurses and unlicensed staff completed a pre-intervention questionnaire measuring their knowledge, attitudes, and practices related to fluid status monitoring. They then completed an education session on fluid status monitoring and the new protocol. This protocol includes use of a fluid balance chart, a standardized daily weight process, and allowed patient participation. The protocol was implemented for 2 months, and the questionnaire was completed again post implementation.
Results: The results were analyzed using a Wilcoxon signed-rank test and a McNemar’s test and a significance value of 5%. The change in how many output measurements participants found challenging was statistically significant and evaluated knowledge (p=0.015). The change in percentage of fluid status documentation participants believed was accurate was found to be significant for attitudes (p= 0.035). For practices, the change in amount of time participants spent documenting was significant (p=0.046).
Discussion: Lack of staff support, resistance to change, and lack of adequate participation were barriers to the project implementation. These barriers were addressed using the PDSA change theory and sufficient planning to motivate and involve staff.
Implications for Practice: This protocol allows for ongoing fluid status monitoring education for staff and improved documentation. Improved documentation allows for higher quality patient outcomes.

Library of Congress Subject Headings

Heart -- Diseases -- Patients.
Body fluids -- Regulation.
Nurses -- Training of.

Number of Pages



South Dakota State University


Copyright @ 2023 Brittni Roberts

Included in

Nursing Commons