OVERVIEW AND INSTRUCTIONS
FOR TRACKING FLUID BETWEEN MEALS
This method for tracking fluid between meals, using the BEVERAGE
ESTIMATION VISUAL (BEV), was designed for use with residents at high risk for malnutrition and/or dehydration who have been designated to be on ”Intake
Watch.” It was also designed for use with residents on fluid restriction, I&Os and „calorie counts.‟
Although technically possible, it would be cumbersome to use the BEV to record and tally between-meal fluid intake for all residents on a routine basis.
BEVERAGE ESTIMATION VISUAL (BEV)
1. The BEV need to be labeled weekly with the resident‟s name, room #,
floor/unit, date and thickness of fluid (if relevant).
a. Option: a computer-printed label with this information can be affixed to
top of the 7-day BEV.
2. A clipboard or binder will hold the BEV (one-two sided sheet per resident) for
all residents on “Intake Watch” on a given unit.
a. Each week a completed BEV will be replaced with a fresh BEV.
Estimation of Fluid Intake.
3. The between-meal fluid estimation method requires that the pre-printed BEV
be accessible to those staff members who are providing fluid to residents
a. BEVs should stay at the nurses station or other designated spot on
each unit so they can be marked when residents on “Intake Watch” are
offered between-meal fluids, including:
i. fluid offerings per medical orders, usually pre-labeled with
ii. spontaneous offering of between-meal fluids;
b. Fluid offerings/intake from a hydration or snack cart between meals
should also be recorded staff who are pushing the cart.
i. The BEV can be carried on the cart during the fluid pass and
then returned to the nurses‟ station.
c. It may also be prudent to record fluid offerings/intake during “med
pass” for those residents at risk for dehydration.
i. Med pass can contribute significantly to fluid intake if substantial
portions of fluid (4-8 oz) are offered each time there are
ii. The BEV can be carried on the medication cart during the med
pass and then returned to the nurses‟ station.
4. Depending on the layout and activities of the facility, it may be necessary to
place additional copies of the BEV for residents on “Intake Watch” in areas of
the facility where residents regularly consume fluids and full-time staff are
available to record intake:
a. Physical Therapy
b. Activities Area
5. After the resident has completed his/her beverage, the responsible staff
member marks the BEV with the beverage provided and the % consumed.
a. Choose from options 0, 25, 50, 75 and 100% consumed.
b. Staff should initial each time they record a drink on the BEV.
c. The staff members who record on the BEV will vary and include:
CNAs, nurses, food and hydration aides, and therapists.
Tallying and Trending of Between-Meal Fluid Intake.
6. Between-meal fluid intakes need to be totaled sometime during the
a. This is best accomplished when the BEV would be least likely to be
utilized by a staff member, e.g. before breakfast or right before lunch.
b. Additional BEVs must also be temporarily retrieved from the physical
therapy room, activities room or other area where fluid intake is being
CONVERSION SHEET FOR TALLYING BETWEEN-MEAL FLUID INTAKE 7. Using the CC
(below), write the cc value in the box where “% Drank” has been marked.
8. Use the calculator to add the cc values of all marked fluid items.
1. Don‟t forget BEVs collected from other areas, like PT or activities.
9. This value should be graphed in the section entitled “CC of Fluid Consumed
Between Meals” on the respective resident‟s FOOD AND FLUID INTAKE TRACKING
a. Mark a ; (dot) on the graph corresponding with total fluid consumed
(100cc, 400cc, etc.) on that day.
10. The DTR, RD or Diet Clerk responsible for physician-ordered “Calorie
Counts” may also gather data from the between meal fluid estimation sheets
when completing calorie calculations.
Discard Between-Meal Fluid Intake Estimation Sheets.
11. After the week‟s BEVs have been tallied and recorded, they may be
a. Completed BEVs will be replaced with fresh BEVs at the end of each
CC CONVERSION SHEET FOR TALLYING BETWEEN-MEAL FLUID INTAKE
BEVERAGE 0 % 25% 50% 75% 100% JUICE / WATER (4 oz) 0 cc 30 cc 60 cc 90 cc 120 cc JUICE / WATER (6 oz) 0 cc 45 cc 90 cc 135 cc 180 cc JUICE / WATER (8 oz) 0 cc 60 cc 120 cc 180 cc 240 cc JUICE / WATER (10 oz) 0 cc 70 cc 140 cc 210 cc 280 cc JUICE / WATER (12 oz) 0 cc 80 cc 160 cc 240 cc 320 cc MILK (8 oz) 0 cc 60 cc 120 cc 180 cc 240 cc MIGHTY SHAKE (6 oz) 0 cc 45 cc 90 cc 135 cc 180 cc SUPPLEMENT (6 oz ) 0 cc 45 cc 90 cc 135 cc 180 cc SODA (8 oz) 0 cc 60 cc 120 cc 180 cc 240 cc SODA (12 oz) 0 cc 90 cc 180 cc 270 cc 360 cc ICE CREAM (4 oz) 0 cc 30 cc 60 cc 90 cc 120 cc COFFEE (8 oz) 0 cc 60 cc 120 cc 180 cc 240 cc SOUP (6 oz) 0 cc 45 cc 90 cc 135 cc 180 cc
( oz) cc cc cc cc cc
( oz) cc cc cc cc cc