Fluid balance in peri-operative and critical care staff

Abstract

Dehydration is known to have detrimental effects on cognitive function and physical performance, as well as increasing the long-term risk of hypertension, coronary heart disease and stroke.1 A number of studies have shown inadequate nutritional and fluid intake in doctors.2,3 There is increasing evidence and interest in the importance of healthcare staff wellbeing and its implications for patient safety.4 A prospective, observational cohort study was conducted on medical and nursing staff working in peri-operative and critical care medicine at a tertiary teaching hospital over a 24 hour period. Fluid balance charts were distributed to staff who were asked to complete these for the duration of their shift. Using 2500 mls as the recommended daily fluid intake1 and average waking hours as 17,5 147 mls/hour was used as the standard with which to compare our results. Analysis was conducted using an unpaired Student t test. One-hundred-and-thirty-five fluid balance charts were distributed and 79 completed, giving a response rate of 58%. Only 3.8% of staff met the recommended fluid intake (n=3). The mean fluid intake was 76 mls/hr (± SD 32). On-call staff had a significantly lower fluid intake than those on normal shifts (24 vs. 78 mls/hr (p=0.005)). Night staff had a higher fluid intake than day staff (93 vs. 72 mls/hr (p=0.043)). Forty-seven percent of drinks consumed were caffeinated (± SD 35%). Staff passed urine 2.2 times per shift (± SD 1.0). This study found inadequate fluid intake amongst most medical and nursing staff. Study participants suggested reasons such as lack of time, limited availability of drinking facilities and staffing shortages. In spite of the small sample size, with over 96% of staff not meeting the recommended fluid intake, our results have potential implications for staff and patient safety. Dehydrated staff may be unable to perform as well cognitively and risk potentially detrimental effects on their short and long-term health. This study adds weight to existing research and highlights the need for fluid promotion among healthcare staff. 1.Benelam B, Wyness L. Nutrition Bulletin. 2010; 35: 3–25.2.Parshuram CS. Canadian Medical Assocociation Journal. 2004; 170: 965–970.3.Lemaire JB, Wallace JE, Dinsmore K, Roberts D. Nutrition Journal. 2011; 10: 18.4.Hamidi MS, Boggild MK, Cheung AM. Postgraduate Medical Journal. 2016; 92: 478–481.5.Nathaniel W, Badr MS, Belenky G, Bliwise DL, Buxton OM. Sleep. 2015; 38: 843–844.