Intake and output record template is a template to record any fluid taken by any patients regularly for specific health evaluation. Recording intake and output tends to be the primary activity to be done at the bedside and is used together with certain laboratory reports to set required fluid intake levels. Accuracy of this activity is vital to facilitate correct prescribing of intravenous and subcutaneous fluids.

This activity should be stated in their medical and nursing notes and should be monitor accurately within defined time period. It should reported in chart format to ease respective patient health analysis. Since patient’s ages will be ranging from infants to elderly, involving patients and their families is an important aspect of ensuring any recording of fluid balance is accurate.

Patients and their families must be informed about the need to record their fluid intake – output. Many patients or their family members are able to contribute to give a hand on provision. The use of visual aids like a cup, a glass with certain volume measurement will not only promote their self care, but ensure everyone including staff are using the same estimates when recording intake – output. This intake and output record template can be used as a reference to do the activity. It has a common format, but you still need to consult with your doctors or hospitals for more details information. Especially, to understand the normal ratio range between fluid intake and output to keep you not to get panic when some conditions are not met.

The intake and output record template can be downloaded below. Feel free to edit it using Microsoft Word.

  Intake and Output Record (17.5 KiB, 1,636 hits)