Daily weight before 8!

Abstract

Background/Significance Accurate and timely daily weight monitoring is an integral part of inpatient nursing care for the heart failure population. Nurses on an inpatient cardiac progressive care unit noticed a consistent lack of daily weight monitoring or inaccurate daily weight documentation. Direct care nurses, champions and leaders decided to implement a new performance improvement (PI) process to improve accurate and timely daily weight monitoring. Methods Daily weight monitoring was performed by obtaining a standing weight between 0400 and 0800. An algorithm was developed to ensure weight documentation was accurate and timely. The slogan, “Daily weight before 8!” was used to educate and encourage staff. A daily report was used to track compliance and trend the weights. As missing weights were identified, feedback was provided to staff and issues such as staffing, equipment, acuity or performance were also addressed in real time. Staff engagement and accountability were key drivers in the PI work. Conclusions Trending accurate weight changes in heart failure patients allowed the care team to better manage patients and evaluate response to therapies. Nurses on the unit showed that a simple nursing intervention such as obtaining an accurate and timely daily weight can impact the plan of care and promote better outcomes. Results Accurate and timely daily weight monitoring improved >10% within 7 months. Thereafter, compliance has remained >90%. Accurate and timely daily weights was identified as having an influence on LOS. LOS was measured by milliman index and correlated to weight compliance.