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Fluid Management and Nursing Outcomes in Patients with Congestive Heart
Failure

K. Chompoo, S. Kumsuk, J. Srichairattanakull, and K. Chosivasakul 1
1
1
1
Faculty of Nursing, Praboromarajchanok Institute, Ministry of Public Health, Thailand
1

Background: Congestion is a critically clinical reason for readmission of patients with heart failure. A lack
of clinical guidelines for continuous care from hospital discharge to home, and a specific nursing care plan
for individuals may play important roles. After discharge, a patient is more likely to retain his/her routine
of daily living and uncontrolled fluid intake. Nurse practitioners in primary health services could enhance
fluid management skills. This study applied Creer’s self-management to develop health education and
fluid management programs. Effects of nursing care on fluid management could lead to reduced risk and
complications in a long term.

Objective: To develop clinical nursing guideline for fluid management of patients with congestive
heart failure

Methods: Four stages were taken as follows 1) health assessment to identify social determinants of health
and health risks; 2) Creer’s self-management was applied to developing a clinical nursing guideline. There
were six steps: setting health goals with patients, collecting related information, analyzing information,
making their own decision, acting on their plan, and evaluating their own goals.; 3) implementation on a
fluid management program; and 4) evaluation on nursing outcomes.

Results: Three levels of nursing outcomes were identified for the fluid management program. First,
a short-term outcome was patients had self-management skills to control their fluid intake and be
able to examine and record their daily body weight. Next, intermediate outcome was patients could
adapt their food consumptions with low fat, low sugar, and low sodium. Finally, a long-term outcome
was after a month of managing fluid management, patients had no incidence of hospital admission.

Conclusion: Self-management is important for preventing congestion. Nurse practitioners could
improve patients’ fluid management to reduce incidence of readmission and improve quality of life.

Keywords: congestive heart failure, self-management, fluid management

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Correspondence: Suwattana Kumsuk, Faculty of Nursing, Praboromarajchanok Institute, Ministry of
Public Health, Thailand
E-mail: suwattana.k@pi.ac.th
Poster Presentation Abstracts

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