Overview and Instructions

for Tracking Fluid Between Meals

Overview

This method for tracking fluid between meals, using the Beverage Estimation Visual (BEV), was designed for use with residents at high risk for malnutrition and/or dehydration who have been designated to be on ”Intake Watch.” It was also designed for use with residents on fluid restriction, I&Os and ‘calorie counts.’

Although technically possible, it would be cumbersome to use the BEV to record and tally between-meal fluid intake for all residents on a routine basis.

Beverage Estimation Visual (BEV)

  1. The BEV need to be labeled weekly with the resident’s name, room #, floor/unit, date and thickness of fluid (if relevant).
  2. Option: a computer-printed label with this information can be affixed to top of the 7-day BEV.
  3. A clipboard or binder will hold the BEV (one-two sided sheet per resident) for all residents on “Intake Watch” on a given unit.
  4. Each week a completed BEV will be replaced with a fresh BEV.

Estimation of Fluid Intake.

  1. The between-meal fluid estimation method requires that the pre-printed BEV be accessible to those staff members who are providing fluid to residents between meals:
  2. BEVs should stay at the nurses station or other designated spot on each unit so they can be marked when residents on “Intake Watch” are offered between-meal fluids, including:
  3. fluid offerings per medical orders, usually pre-labeled with resident’s name;
  4. spontaneous offering of between-meal fluids;
  5. Fluid offerings/intake from a hydration or snack cart between meals should also be recorded staff who are pushing the cart.
  6. The BEV can be carried on the cart during the fluid pass and then returned to the nurses’ station.
  7. It may also be prudent to record fluid offerings/intake during “med pass” for those residents at risk for dehydration.
  8. Med pass can contribute significantly to fluid intake if substantial portions of fluid (4-8 oz) are offered each time there are “medication rounds.”
  9. The BEV can be carried on the medication cart during the med pass and then returned to the nurses’ station.

  1. Depending on the layout and activities of the facility, it may be necessary to place additional copies of the BEV for residents on “Intake Watch” in areas of the facility where residents regularly consume fluids and full-time staff are available to record intake:
  2. Physical Therapy
  3. Activities Area
  4. After the resident has completed his/her beverage, the responsible staff member marks the BEV with the beverage provided and the % consumed.
  5. Choose from options 0, 25, 50, 75 and 100% consumed.
  6. Staff should initial each time they record a drink on the BEV.
  7. The staff members who record on the BEV will vary and include: CNAs, nurses, food and hydration aides, and therapists.

Tallying and Trending of Between-Meal Fluid Intake.

  1. Between-meal fluid intakes need to be totaled sometime during the subsequent day.
  2. This is best accomplished when the BEV would be least likely to be utilized by a staff member, e.g. before breakfast or right before lunch.
  3. Additional BEVs must also be temporarily retrieved from the physical therapy room, activities room or other area where fluid intake is being recorded.
  4. Using the CC Conversion Sheet for Tallying Between-Meal Fluid Intake (below), write the cc value in the box where “% Drank” has been marked.
  5. Use the calculator to add the cc values of all marked fluid items.
  1. Don’t forget BEVs collected from other areas, like PT or activities.
  1. This value should be graphed in the section entitled “CC of Fluid Consumed Between Meals” on the respective resident’s Food and Fluid Intake Tracking form.
  2. Mark a  (dot) on the graph corresponding with total fluid consumed (100cc, 400cc, etc.) on that day.

Calorie Counts.

  1. The DTR, RD or Diet Clerk responsible for physician-ordered “Calorie Counts” may also gather data from the between meal fluid estimation sheets when completing calorie calculations.

Discard Between-Meal Fluid Intake Estimation Sheets.

  1. After the week’s BEVs have been tallied and recorded, they may be discarded.
  2. Completed BEVs will be replaced with fresh BEVs at the end of each week.

CC Conversion Sheet for Tallying Between-Meal Fluid Intake

PERCENT DRANK

BEVERAGE / 0 % / 25% / 50% / 75% / 100%

JUICE / WATER (4 oz)

/ 0 cc / 30 cc / 60 cc / 90 cc / 120 cc

JUICE / WATER (6 oz)

/ 0 cc / 45 cc / 90 cc / 135 cc / 180 cc

JUICE / WATER (8 oz)

/ 0 cc / 60 cc / 120 cc / 180 cc / 240 cc

JUICE / WATER (10 oz)

/ 0 cc / 70 cc / 140 cc / 210 cc / 280 cc

JUICE / WATER (12 oz)

/ 0 cc / 80 cc / 160 cc / 240 cc / 320 cc
MILK (8 oz) / 0 cc / 60 cc / 120 cc / 180 cc / 240 cc
MIGHTY SHAKE (6 oz) / 0 cc / 45 cc / 90 cc / 135 cc / 180 cc
SUPPLEMENT (6 oz ) / 0 cc / 45 cc / 90 cc / 135 cc / 180 cc
SODA (8 oz) / 0 cc / 60 cc / 120 cc / 180 cc / 240 cc
SODA (12 oz) / 0 cc / 90 cc / 180 cc / 270 cc / 360 cc
ICE CREAM (4 oz) / 0 cc / 30 cc / 60 cc / 90 cc / 120 cc
COFFEE (8 oz) / 0 cc / 60 cc / 120 cc / 180 cc / 240 cc
SOUP (6 oz) / 0 cc / 45 cc / 90 cc / 135 cc / 180 cc
( oz) / cc / cc / cc / cc / cc
( oz) / cc / cc / cc / cc / cc

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