Title : Enhancing the accuracy of intake and output on an oncology unit
Abstract:
Accurate Intake and Output (I/O) documentation is essential in oncology care, as patients are highly susceptible to fluid and electrolyte imbalances, renal dysfunction, and treatment-related complications. Despite its clinical importance, I/O documentation is often inconsistent, potentially delaying treatment decisions and compromising patient safety. The purpose of this Doctor of Nursing Practice (DNP) quality improvement project was to improve nursing knowledge and documentation accuracy on a 36-bed hematology-oncology unit at a National Cancer Institute–designated facility. Guided by the Iowa Model of Evidence-Based Practice, interventions included targeted staff education, laminated nursing reference guides, and patient-friendly I/O trackers. Project evaluation consisted of pre- and post-intervention nursing knowledge surveys and chart audits comparing documentation practices across two eight-week periods. Outcomes included improved accuracy and consistency of I/O documentation, enhanced nursing knowledge of fluid balance principles, and strengthened collaboration between nurses and providers. By embedding education and visual tools into daily workflows, this project supports improved patient safety, quality of care, and sustainable documentation practices in high-acuity inpatient settings.
