Improving hydration of care home residents by increasing choice and opportunity to drink: A quality improvement study.
Care homes
Fluid intakes
Hydration
Older people
Quality improvement
Journal
Clinical nutrition (Edinburgh, Scotland)
ISSN: 1532-1983
Titre abrégé: Clin Nutr
Pays: England
ID NLM: 8309603
Informations de publication
Date de publication:
08 2019
08 2019
Historique:
received:
08
03
2018
revised:
09
07
2018
accepted:
14
07
2018
pubmed:
29
8
2018
medline:
4
9
2020
entrez:
29
8
2018
Statut:
ppublish
Résumé
Dehydration is recognised as an important problem among care home residents and can be associated with severe consequences. Insufficient provision of fluids to meet resident preferences and lack of assistance to drink have been identified as key factors driving under-hydration of care home residents. Using targeted interventions, this study aimed to optimise hydration care for frail older people in a care home setting. The study used quality improvement methods to develop and test interventions to extend drinking opportunities and choice in two care homes. Changes were made and evaluated using Plan-Do-Study-Act (PDSA) cycles. Data were captured on the amount of fluids served and consumed, and staff and resident feedback. The long-term impact of the interventions was assessed by measuring daily laxative and antibiotic consumption, weekly incidence of adverse health events, and average fluid intake of a random sample of six residents captured monthly. The interventions were associated with an increase in the amount and range of fluids consumed, in one home mean fluid intakes exceeded 1500 ml for three consecutive months. Laxative use decreased significantly in both homes. A number of practical and organisational barriers affected the sustainability of interventions. Interventions to optimise the hydration of care home residents can be effective. Plan-Do-Study-Act cycles provide an effective methodology to implement new interventions into existing practice in care homes. Sustainable change requires strong leadership, organisational support and teamwork.
Sections du résumé
BACKGROUND & AIMS
Dehydration is recognised as an important problem among care home residents and can be associated with severe consequences. Insufficient provision of fluids to meet resident preferences and lack of assistance to drink have been identified as key factors driving under-hydration of care home residents. Using targeted interventions, this study aimed to optimise hydration care for frail older people in a care home setting.
METHODS
The study used quality improvement methods to develop and test interventions to extend drinking opportunities and choice in two care homes. Changes were made and evaluated using Plan-Do-Study-Act (PDSA) cycles. Data were captured on the amount of fluids served and consumed, and staff and resident feedback. The long-term impact of the interventions was assessed by measuring daily laxative and antibiotic consumption, weekly incidence of adverse health events, and average fluid intake of a random sample of six residents captured monthly.
RESULTS
The interventions were associated with an increase in the amount and range of fluids consumed, in one home mean fluid intakes exceeded 1500 ml for three consecutive months. Laxative use decreased significantly in both homes. A number of practical and organisational barriers affected the sustainability of interventions.
CONCLUSIONS
Interventions to optimise the hydration of care home residents can be effective. Plan-Do-Study-Act cycles provide an effective methodology to implement new interventions into existing practice in care homes. Sustainable change requires strong leadership, organisational support and teamwork.
Identifiants
pubmed: 30150005
pii: S0261-5614(18)31222-6
doi: 10.1016/j.clnu.2018.07.020
pii:
doi:
Substances chimiques
Laxatives
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1820-1827Subventions
Organisme : Department of Health
Pays : United Kingdom
Informations de copyright
Copyright © 2018 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.