Recurring concern
Failure to reliably monitor patient fluid balance
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Request correctionFirst reported 28 Aug 2013•Latest report 22 Dec 2025
What this concern includes
Includes failures of the dedicated patient fluid-balance monitoring process, including failure to initiate, assess, measure, record or maintain monitoring, and delayed or incomplete monitoring when fluid status is clinically important.
Not included
- Excludes failures limited to recording fluid-balance information when monitoring itself was completed reliably.
- Excludes generic clinical information, staffing or documentation deficiencies unless they directly cause failure of the patient fluid-balance monitoring process.
- Excludes monitoring of other physiological measures unless the assertion specifically concerns patient fluid balance.
- Excludes treatment or fluid-management decisions where no failure of fluid-balance monitoring is identified.
- Reports
- 29
- Individual concerns
- 34
- Date range
- 2013–2025
- Stated actions
- 78
Distinct published reports
A report can raise multiple concerns
First to latest report issue date
Described in published responses
Reports over time
Reports over time
Reports about this concern issued each year.
* 2026 is projected from reports observed to 7 Sep 2026.
Most frequent recipients
Most frequent recipients
Reports about this concern sent to each recipient.
Concerns and responses across reports
Only concerns grouped under this recurring concern are included. Select any concern, action or position to view the source wording.
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Concerns raised1
Failure to accurately monitor fluid intake and output
This report raised 1 other concern. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concernsEach statement is shown once, even when linked to more than one concern.
No linked response statementsNo respondent-stated action or position is linked to these concerns in the published data.
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Concerns raised1
Failure to accurately measure urine output
This report raised 4 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concernsEach statement is shown once, even when linked to more than one concern.
No linked response statementsNo respondent-stated action or position is linked to these concerns in the published data.
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Concerns raised1
Failure to accurately record routine observations, fluid balance and gastrointestinal losses
This report raised 6 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concernsEach statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.5
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Action
Run an awareness campaign emphasising accurate fluid-balance documentation on Joan Booker Ward.
Stated by Ashford and St Peter'S Hospitals NHS Foundation Trust -
Action
Introduce training and competency assessments for staff completing fluid-balance charts.
Stated by Ashford and St Peter'S Hospitals NHS Foundation Trust -
Action
Develop a redesigned fluid-balance chart to support complete recording of patient input and output.
Stated by Ashford and St Peter'S Hospitals NHS Foundation Trust
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Action
Conduct a repeat in-depth audit of fluid-balance documentation after the new chart is introduced and embedded.
Stated by Ashford and St Peter'S Hospitals NHS Foundation Trust -
Action
Introduce the Vitalpac electronic system for capturing patient observations across most inpatient areas.
Stated by Ashford and St Peter'S Hospitals NHS Foundation Trust
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Concerns raised1
Failure to complete fluid balance charts consistently and accurately
This report raised 4 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concernsEach statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.2
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Action
Review the fluid balance chart and its relationship to the Trust Nutrition and Hydration Policy.
Stated by Leicestershire Partnership NHS Trust -
Action
Implement the reviewed fluid-balance documentation approach and support it with training for all clinical staff.
Stated by Leicestershire Partnership NHS Trust
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Concerns raised1
Failure to record fluid intake and output
This report raised 24 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concernsEach statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.2
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Action
Monitor documentation more closely and provide nurses with real-time feedback.
Stated by University Hospitals Sussex NHS Foundation Trust -
Action
Review and condense Acute Medical Unit documentation into multidisciplinary paperwork that directs care and reduces duplication.
Stated by University Hospitals Sussex NHS Foundation Trust
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Concerns raised1
Failure to assess and monitor post operative fluid balance
This report raised 6 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concernsEach statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.6
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Action
Implement national-standard Early Warning Score paperwork and provide recurring staff training on deterioration recognition and fluid-balance monitoring.
Stated by Survey and Sussex NHS Healthcare NHS Trust -
Action
Provide Sepsis, Acute Kidney Injury and fluid-balance monitoring study days for ward nurses.
Stated by Survey and Sussex NHS Healthcare NHS Trust -
Action
Deliver ward-based teaching on patient assessment, acute kidney injury and fluid balance, with further sessions planned during 2015.
Stated by Survey and Sussex NHS Healthcare NHS Trust
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Action
Restart ALERT courses covering deterioration recognition, acute kidney injury and fluid-balance charts.
Stated by Survey and Sussex NHS Healthcare NHS Trust -
Action
Start BEACH courses in April 2015, including fluid-balance monitoring training.
Stated by Survey and Sussex NHS Healthcare NHS Trust -
Action
Conduct a Trust-wide audit of fluid-balance chart completion during 2015.
Stated by Survey and Sussex NHS Healthcare NHS Trust
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Concerns raised1
Failure to keep fluid balance charts properly
This report raised 11 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concernsEach statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.1
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Action
Improve fluid-balance documentation through contemporaneous recording, two-hourly chart review during intentional rounding, and checks before shift handover.
Stated by Stockport NHS Foundation Trust
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Concerns raised1
Failure to commence fluid balance charts for patients receiving intravenous fluids
This report raised 8 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concernsEach statement is shown once, even when linked to more than one concern.
No linked response statementsNo respondent-stated action or position is linked to these concerns in the published data.
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Concerns raised1
Lack of direct monitoring of oral input and urinary output at the care home
This report raised 2 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concernsEach statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.2
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Action
Review and revise the catheter-care and fluid-input/output procedures.
Stated by the proprietor of Monkstone House Residential Home of 1 Locks Common, Porthcawl, CF36 3HU -
Action
Implement urinary input and output monitoring charts for all clients.
Stated by the proprietor of Monkstone House Residential Home of 1 Locks Common, Porthcawl, CF36 3HU
Data last updated 7 September 2026