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Miller C, Mcloughlin AS, Benedetto V, Christian DL, Jones SP, Smith E, Watkins CL. Diagnosis and treatment of dehydration after stroke: A synthesis of existing evidence. BRITISH JOURNAL OF NEUROSCIENCE NURSING 2023; 19:S24-S32. [PMID: 38812878 PMCID: PMC7616033 DOI: 10.12968/bjnn.2023.19.sup5.s24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2024]
Abstract
Dehydration after stroke is associated with poor health outcomes, increased mortality, and poses a significant economic burden to health services. Yet research suggests that monitoring and assessment of hydration status is not routinely undertaken. In this commentary, we critically appraise a systematic review which aimed to synthesise the existing evidence regarding diagnosis and treatment of dehydration after stroke. The review discusses common measures of dehydration, describes studies evaluating rehydration treatments, and highlights the link between dehydration and poorer health outcomes in both human and animal studies. The reviewers suggest, future research should focus on determining a single, validated, objective measure to clinically diagnose dehydration in stroke patients. Research designs should include clearly defined patient characteristics, type and severity of stroke, and type and time point of dehydration measurement, to enable comparison between studies. Management of hydration status is a crucial element of acute stroke care which should be routinely practiced.
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Affiliation(s)
- Colette Miller
- IMPlementation and Capacity building Team (IMPaCT), Applied Health Research Hub, University of Central of Central Lancashire (UCLan), Preston
- Stroke Research Team, School of Nursing and Midwifery, UCLan, Preston
- NIHR Applied Research Collaboration North West Coast (ARC NWC), UCLan, Preston
| | - Alison S.R. Mcloughlin
- IMPlementation and Capacity building Team (IMPaCT), Applied Health Research Hub, University of Central of Central Lancashire (UCLan), Preston
- NIHR Applied Research Collaboration North West Coast (ARC NWC), UCLan, Preston
| | - Valerio Benedetto
- NIHR Applied Research Collaboration North West Coast (ARC NWC), UCLan, Preston
- Methodological Innovation, Development, Adaptation & Support Theme (MIDAS), Applied Health Research Hub, University of Central
| | - Danielle L. Christian
- IMPlementation and Capacity building Team (IMPaCT), Applied Health Research Hub, University of Central of Central Lancashire (UCLan), Preston
- NIHR Applied Research Collaboration North West Coast (ARC NWC), UCLan, Preston
| | | | - Eleanor Smith
- NIHR Applied Research Collaboration North West Coast (ARC NWC), UCLan, Preston
| | - Caroline L. Watkins
- IMPlementation and Capacity building Team (IMPaCT), Applied Health Research Hub, University of Central of Central Lancashire (UCLan), Preston
- Stroke Research Team, School of Nursing and Midwifery, UCLan, Preston
- NIHR Applied Research Collaboration North West Coast (ARC NWC), UCLan, Preston
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Abudu-Birresborn D, Brennenstuhl S, Puts M, McCleary L, Yakong V, Chu CH, Cranley L. Evaluating knowledge and attitudes scales for the care of older adults among nursing students in Ghana. BMC Nurs 2023; 22:47. [PMID: 36805691 PMCID: PMC9942360 DOI: 10.1186/s12912-023-01195-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 01/31/2023] [Indexed: 02/23/2023] Open
Abstract
BACKGROUND Understanding nursing students' knowledge about and attitudes toward older adults' using context-specific survey instruments can help to identify and design effective learning and teaching materials to improve the care for persons 60 years and above. However, there are no validated instruments to examine nursing students' knowledge and attitudes toward the care for older adults in the African context. The study aimed to evaluate the items on the Knowledge about Older Patients Quiz and Kogan's Attitudes towards Old People Scale suitable for the African context. METHODS A cross-sectional study was conducted using second-and third-year nursing students from two public Nursing Training Institutions in Ghana. Using Sahin's rule of sample size estimate of at least 150 participants for unidimensional dichotomous scales, 170 nursing students were recruited to participate after an information session in their classrooms. Data were collected from December 2019-March 2020 using the Knowledge about Older Patients Quiz and Kogan's Attitudes Towards Old People Scale. Item response theory was employed to evaluate the Knowledge about Older Patients Quiz difficulty level and discrimination indices. Corrected item-to-total correlation analysis was conducted for Kogan's Attitudes towards Old People Scale. The internal consistency for both scales was examined. RESULTS Of the 170 participants, 169 returned completed surveys. The mean age of participants was 21 years (SD = 3.7), and (54%) were female. Of the 30-items of the Knowledge about Older Patients Quiz, seven items were very difficult for most students to choose the correct response, and one was easy, as most of the students chose the correct response. Although 22 items demonstrated appropriate difficulty level, discrimination indices were used to select the final 15- items that discriminated moderately between upper and lower 25% performing students. The Kuder-Richardson-20 reliability was. 0.30, which was low. Considering Kogan's Attitudes towards Old People scale, 10-items were removed following negative and low corrected item-to-total correlation and a high Alpha coefficient if items were deleted. The final 22-items had a Cronbach alpha coefficient of 0.65, which was moderately satisfactory. CONCLUSION Evaluation of the scales demonstrated essential content validity and moderate internal consistency for the context of our study. Further research should focus on ongoing context-specific refinement of the survey instruments to measure nursing students' knowledge about and attitudes toward caring for older adults in the African context.
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Affiliation(s)
- Diana Abudu-Birresborn
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College Street, Suite 130, Toronto, ON, M5T 1P8, Canada.
| | - Sarah Brennenstuhl
- grid.17063.330000 0001 2157 2938Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College Street, Suite 130, Toronto, ON M5T 1P8 Canada
| | - Martine Puts
- grid.17063.330000 0001 2157 2938Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College Street, Suite 130, Toronto, ON M5T 1P8 Canada
| | - Lynn McCleary
- grid.411793.90000 0004 1936 9318Department of Nursing, Brock University, 1812 Sir Isaac Brock Way, St. Catharine’s, ON L2S 3A1 Canada
| | - Vida Yakong
- grid.442305.40000 0004 0441 5393School of Nursing and Midwifery, University for Development Studies, Box 1350, Tamale, Ghana
| | - Charlene H. Chu
- grid.17063.330000 0001 2157 2938Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College Street, Suite 130, Toronto, ON M5T 1P8 Canada
| | - Lisa Cranley
- grid.17063.330000 0001 2157 2938Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College Street, Suite 130, Toronto, ON M5T 1P8 Canada
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Çetin P, Eşer I. Effect of an Audible Alarm on the Fluid Consumption of Older Adults Living in a Nursing Home: A Randomized Controlled Trial. J Gerontol Nurs 2022; 48:39-46. [PMID: 36007210 DOI: 10.3928/00989134-20220808-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The aim of the current study was to investigate the effect of an audible alarm on fluid consumption among older adults living in a nursing home. This single-blind, randomized controlled, prospective experimental study was performed between July 27, 2017, and February 1, 2018. This study comprised 100 participants (intervention group, n = 50; control group, n = 50). The amount of fluid consumed by older adults in the intervention group in relation to the audible alarm increased significantly compared to the control group, and the deficiency of fluid consumption decreased. It was determined that the wristwatch with audible alarm was effective when used as a reminder to increase fluid consumption among older adults with fluid deficiency. [Journal of Gerontological Nursing, 48(9), 39-46.].
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Rosi IM, Milos R, Cortinovis I, Laquintana D, Bonetti L. Sensitivity and specificity of the new Geriatric Dehydration Screening Tool: an observational diagnostic study. Nutrition 2022; 101:111695. [DOI: 10.1016/j.nut.2022.111695] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 03/10/2022] [Accepted: 04/08/2022] [Indexed: 10/18/2022]
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Keller H, Wei C, Slaughter S, Yoon MN, Lengyel C, Namasivayam-Macdonald A, Martin L, Heckman G, Gaspar P, Mentes J, Syed S. Qualitative analysis of a virtual research meeting summarises expert-based strategies to promote hydration in residential care during COVID-19 and beyond. BMJ Open 2022; 12:e055457. [PMID: 35135772 PMCID: PMC8829846 DOI: 10.1136/bmjopen-2021-055457] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVES Poor fluid intake is a complex and long-standing issue in residential care, further exacerbated by COVID-19 infection control procedures. There is no consensus on how best to prevent dehydration in residents who vary in their primary reasons for insufficient fluid intake for a variety of reasons. The objectives of this research were to determine expert and provider perspectives on: (1) how COVID-19 procedures impacted hydration in residential care and potential solutions to mitigate these challenges and (2) strategies that could target five types of residents based on an oral hydration typology focused on root causes of low fluid intake. DESIGN Qualitative study based on virtual group discussion. The discussion was audiorecorded with supplementary field notes. Qualitative content analysis was completed. SETTING Residential care. PARTICIPANTS 27 invited researcher and provider experts. RESULTS Challenges that have potentially impacted hydration of residents because of COVID-19 procedures were categorised as resident (eg, apathy), staff (eg, new staff) and home-related (eg, physical distancing in dining rooms). Potential solutions were offered, such as fun opportunities (eg, popsicle) for distanced interactions; training new staff on how to approach specific residents and encourage drinking; and automatically providing water at meals. Several strategies were mapped to the typology of five types of residents with low intake (eg, sipper) and categorised as: supplies (eg, vessels with graduated markings), timing (eg, identify best time of day for drinking), facility context (eg, identify preferred beverages), socialisation (eg, promote drinking as a social activity) and education (eg, educate cognitively well on water consumption goals). CONCLUSIONS COVID-19 has necessitated new procedures and routines in residential care, some of which can be optimised to promote hydration. A variety of strategies to meet the hydration needs of different subgroups of residents can be compiled into multicomponent interventions for future research.
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Affiliation(s)
- Heather Keller
- Schlegel-UW Research Institute for Aging, Waterloo, Ontario, Canada
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Cindy Wei
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Susan Slaughter
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Minn N Yoon
- School of Dentistry, University of Alberta Faculty of Medicine and Dentistry, Edmonton, Alberta, Canada
| | - Christina Lengyel
- Department of Food and Human Nutritional Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | | | - Laurel Martin
- Department of Food and Human Nutritional Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - George Heckman
- Schlegel-UW Research Institute for Aging, Waterloo, Ontario, Canada
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | | | - Janet Mentes
- School of Nursing, University of California Los Angeles, Los Angeles, California, USA
| | - Safura Syed
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
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Shaban M, Mohammed H, Hassan S. Role of community health nurse in the prevention of elderly dehydration: A mini-review. JOURNAL OF INTEGRATIVE NURSING 2022. [DOI: 10.4103/jin.jin_36_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
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Narrative Review of Low-Intake Dehydration in Older Adults. Nutrients 2021; 13:nu13093142. [PMID: 34579019 PMCID: PMC8470893 DOI: 10.3390/nu13093142] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 09/08/2021] [Accepted: 09/08/2021] [Indexed: 12/17/2022] Open
Abstract
Low-intake dehydration is a common and often chronic condition in older adults. Adverse health outcomes associated with low-intake dehydration in older adults include poorer cognitive performance, reduced quality of life, worsened course of illness and recovery, and a high number of unplanned hospital admissions and increased mortality. The subjective methods to assess (risk of) dehydration are not reliable, and the evidence about preventive measures are also limited. So is the knowledge about the optimal intake of beverages per day. This narrative review presents the state of the science on the role of low intake hydration in older adults. Despite its simple cause—the inadequate intake of beverages—low-intake dehydration appears to be a very complex problem to address and much more research is needed in the area. Based on the existing evidence, it seems necessary to take setting specific differences and individual problems and needs into account to tackle dehydration in older adults. Further, it is necessary to increase awareness of the prevalence and severity of low-intake dehydration among older adults and in nursing staff in care homes and hospitals as well as among caregivers of older adults living at home.
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Paulis SJC, Everink IHJ, Halfens RJG, Lohrmann C, Schols JMGA. Dehydration in the nursing home: Recognition and interventions taken by Dutch nursing staff. J Adv Nurs 2021; 78:1044-1054. [PMID: 34462958 PMCID: PMC9290809 DOI: 10.1111/jan.15032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 08/07/2021] [Accepted: 08/20/2021] [Indexed: 11/28/2022]
Abstract
Aims To examine which signs/symptoms registered nurses (RNs) and certified nurse assistants (CNAs) (nursing staff) in Dutch nursing homes associate with dehydration, if they observe these signs/symptoms themselves and what they do after observing them. Design A cross‐sectional study. Methods In February 2020, using an online questionnaire based on a diagnostic strategy to diagnose dehydration, nursing staff was asked: (1) which signs/symptoms they associate with dehydration; (2) if they observe these signs/symptoms themselves; and (3) which actions they take after observing these signs/symptoms in a resident. Descriptive statistics and Chi‐square statistics were used to describe the answers and explore significant differences between groups. Results In total, 250 RNs and 226 CNAs participated. Among RNs, 67%–99% associated the signs/symptoms of the strategy to dehydration compared with 45%–98% of the CNAs. RNs and CNAs often indicated to observe signs/symptoms from the strategy themselves (80.1% and 92.6%), but they also often relied on information given by other care professionals and the informal caregiver. Interventions taken were mainly focused on communicating findings to colleagues. Conclusion Many signs/symptoms from the diagnostic strategy trigger nursing staff to think of dehydration. Results also show that a variety of formal and informal caregivers are involved in dehydration care. As RNs and CNAs did often not receive dehydration training after entering workforce, this could have limited their ability to recognize signs/symptoms related to dehydration. To ensure timely recognition of dehydration, a clear description of roles and responsibilities about dehydration care in, and between, formal and informal caregivers is essential with structurally embedded dehydration training in the nursing home. Impact Tackling dehydration in the nursing home requires interdisciplinary collaboration and communication with family members. Without clear roles and responsibilities, a risk of dehydration can be left unattended.
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Affiliation(s)
- Simone J C Paulis
- Department of Health Services Research, Care Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Irma H J Everink
- Department of Health Services Research, Care Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Ruud J G Halfens
- Department of Health Services Research, Care Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Christa Lohrmann
- Institute of Nursing Science, Medical University of Graz, Graz, Austria
| | - Jos M G A Schols
- Department of Health Services Research, Care Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands.,Department of Family Medicine, Care Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
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Uyanık G, Dağhan Ş. Effect of a Hydration Management Program on Older Adults' Fluid Consumption and Dehydration Parameters: A Quasi-Experimental Study. J Gerontol Nurs 2021; 47:40-48. [PMID: 34432569 DOI: 10.3928/00989134-20210803-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The purpose of the current study was to assess effects of a hydration management program on the fluid consumption and dehydration parameters (i.e., dehydration risk scores, urine specific gravity, and urine color) of older adults. The study was conducted as a pre-/post-test quasi-experimental study with a control group (intervention group: n = 42, control group: n = 37). The hydration management program applied to the intervention group was completed in 1 week. After the intervention, the knowledge and awareness of the intervention group regarding fluid consumption increased (p = 0.001). The dehydration risk score of the intervention group was significantly lower than that of the control group (p = 0.0001). There was a significant change in average 3-day water intake (p = 0.0001), urine specific gravity value (p = 0.01), and urine color scale score (p = 0.0001) in the intervention group between pre- and post-test. The hydration management program provided a significant improvement in daily water intake and dehydration risk score and increased knowledge and awareness among older adults concerning the importance of fluid intake. [Journal of Gerontological Nursing, 47(9), 40-48.].
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Maintaining oral hydration in older adults in surgical wards: a best practice implementation project. JBI Evid Implement 2021; 20:63-71. [PMID: 34282093 DOI: 10.1097/xeb.0000000000000289] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
INTRODUCTION AND AIM Oral hydration is essential in older adults as poor hydration can complicate existing medical conditions and increase morbidity. Older adults in surgical wards are at risk of dehydration due to insufficient fluid consumption. The aim of this project is to ensure patients aged 65 years and above are adequately hydrated. METHODS The current project was conducted over 7 months from February to August 2019 and involved pre and postimplementation audits to ensure compliance with best practice. The Joanna Briggs Institute Practical Application of Clinical Evidence System and the Getting Research into Practice tools were used as a guide. Audits were conducted at four surgical wards with a sample of 42 patients at each audit. The measures implemented include educating nurses on the importance of oral hydration in older adult patients and labelling water jugs to encourage fluid intake among these patients. RESULTS Nurses' compliance in monitoring older adult patients' daily fluid intake increased from 5 to 76% at follow-up audit (P < 0.05). In addition, the average amount of fluid consumed over 3 days increased from 858.23 to 1037.50 ml. CONCLUSION This project demonstrated a significant increase in oral fluid intake among older adult patients during hospitalization and their understanding of adequate fluid intake. Nurses play an important role in ensuring adequate amounts of daily fluid intake by these patients.
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Gaspar PM, Scherb CA, Rivera-Mariani F. Hydration Status of Assisted Living Memory Care Residents. J Gerontol Nurs 2019; 45:21-29. [PMID: 30917202 DOI: 10.3928/00989134-20190213-02] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Accepted: 01/18/2019] [Indexed: 11/20/2022]
Abstract
Water intake and hydration status of assisted living memory care (ALMC) residents were evaluated. Thirty-two residents (eight men; mean age 86.5 years; Global Deterioration Scale [GDS] 3 to 7) from four ALMC units participated. Ingested food and fluid amount, type, and time, and ingestion behaviors were observed from 7:00 a.m. to 7:00 p.m. Related factors were obtained from chart review/participant survey. Mean fluid intake was 1,160.16 mL; mean water intake from food and fluid was 56.55% (SD = 23.4%) of recommended water intake (RWI). Only one participant met 100% RWI. Using osmolality laboratory results (available for 21 participants), five participants were hydrated, whereas eight (38.1%) participants were in impending dehydration and dehydration categories, respectively. Fluid intake, GDS, and level of assistance during meals predicted RWI. Water intake of ALMC residents is inadequate, placing them at risk for dehydration, and justifies development and implementation of care standards for increasing water intake. [Journal of Gerontological Nursing, 45(4), 21-29.].
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Meehan AJ, Maher AB, Brent L, Copanitsanou P, Cross J, Kimber C, MacDonald V, Marques A, Peng L, Queirós C, Roigk P, Sheehan KJ, Skúladóttir SS, Hommel A. The International Collaboration of Orthopaedic Nursing (ICON): Best practice nursing care standards for older adults with fragility hip fracture. Int J Orthop Trauma Nurs 2019; 32:3-26. [DOI: 10.1016/j.ijotn.2018.11.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Steven A, Wilson G, Young-Murphy L. The Implementation of an Innovative Hydration Monitoring App in Care Home Settings: A Qualitative Study. JMIR Mhealth Uhealth 2019; 7:e9892. [PMID: 30694207 PMCID: PMC6371068 DOI: 10.2196/mhealth.9892] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 09/26/2018] [Accepted: 10/07/2018] [Indexed: 11/25/2022] Open
Abstract
Background In response to marked concern regarding inadequate fluid intake recording in care homes, an innovative mobile hydration app was collaboratively developed. “Hydr8” aimed to facilitate accurate recording and communication of residents’ fluid intake and ultimately increase care quality and patient safety. Objective The aim of this study was to examine the implementation of Hydr8 in a sample of care homes in one area in England. Methods The principles of Realist Evaluation and Action research were drawn upon throughout the study. Overall, 5 care homes participated in this study, 3 interview-only sites and 2 case-study sites, where interviews and observations were conducted at 3 time-points. Furthermore, 28 staff members participated, including care staff, management, a registered nurse, and administrative staff. Results Findings suggest that Hydr8 benefits practice, enhancing the understanding of hydration and person-centered care and improving staff communication. However, technical glitches hindered the seamless embedding of Hydr8 into everyday practice, and enthusiasm for long-term use was dependent on the resolution of issues. In addition, Hydr8 heightened perceptions of personal accountability, and while managers viewed this as positive, some staff members were apprehensive. However, individuals were enthusiastic about the long-term use and potential of Hydr8. Conclusions Utilizing the findings of this study to further develop and adapt Hydr8 indicates the long-term use of Hydr8 as promising. Although perceptions of Hydr8 were primarily positive, setbacks in its implementation and use created difficulties in normalizing the solution into everyday practice. This study highlights the need for education related to hydration practice and a change of infrastructure in care home settings to implement technical solutions and changes to care.
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Affiliation(s)
- Alison Steven
- Department of Nursing, Midwifery and Health, Faculty of Health and Life Sciences, Northumbria University Newcastle, Newcastle upon Tyne, United Kingdom
| | - Gemma Wilson
- Department of Nursing, Midwifery and Health, Faculty of Health and Life Sciences, Northumbria University Newcastle, Newcastle upon Tyne, United Kingdom
| | - Lesley Young-Murphy
- NHS North Tyneside Clinical Commissioning Group, North Shields, United Kingdom
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Duarte M, Bouça-Machado R, Domingos J, Godinho C, Ferreira JJ. Feasibility of using risk prompts to prevent falls, dehydration and pulmonary aspiration in nursing homes: a clinical study protocol. Pilot Feasibility Stud 2018; 4:39. [PMID: 29416872 PMCID: PMC5785817 DOI: 10.1186/s40814-018-0236-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Accepted: 01/16/2018] [Indexed: 02/07/2023] Open
Abstract
Background Evidence has shown a relationship between dehydration, falls, and pulmonary aspiration among older adults in nursing homes, all of which contribute to loss of independence and quality of life. It is believed that improving communication among healthcare professionals in nursing homes (physicians, nurses, rehabilitation team, psychologist, social workers, dieticians and medical assistants) decreases the number of adverse events in institutionalized patients. This study will evaluate the feasibility of using a set of written signs, designed to caution against the risk of falls, dehydration, and pulmonary aspiration, and will enable the proposal of tailored interventions to manage these events in nursing homes. Methods/Design All patients from Campus Neurológico Sénior (CNS) nursing home, at risk of falls and/ordysphagia and/or dehydration will be invited to participate in the study. Patients will undertake a screeningrisk assessment and the corresponding risk prompts will be attributed. Study duration will be a minimum ofthree months per participant, including daily record of falls, dehydration and pulmonary aspiration eventsand monthly interview assessments, conducted by a member of the research team. Data of the events that occur will be compared with historical data extracted retrospectively from medical and nursing charts. This study has been approved by the Ethics Committee of the Medical Academic Center of Lisbon, Faculty of Medicine, University of Lisbon (Ref. 176/15). All participants will give their written informed consent before entering the study. Discussion This study is unique in evaluating the feasibility of a communication system in preventing the three major risks in nursing home. Thoughtful selection and display of proper risk prompts in nursing homes could be an essential step along a path toward efficient communication of risks among healthcare teams. We expect that the displays will be easily applicable given their simplicity, low complexity, and minimal physical requirements. Trial registration NCT03123601. March 7, 2017. Retrospectively registered.
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Affiliation(s)
- Márcia Duarte
- CNS-Campus Neurológico Sénior, Torres Vedras, Portugal
| | - Raquel Bouça-Machado
- CNS-Campus Neurológico Sénior, Torres Vedras, Portugal.,2Instituto de Medicina Molecular, Lisbon, Portugal
| | | | - Catarina Godinho
- CNS-Campus Neurológico Sénior, Torres Vedras, Portugal.,2Instituto de Medicina Molecular, Lisbon, Portugal.,3Centro de Investigação Interdisciplinar Egas Moniz, Escola Superior de Saúde Egas Moniz, Monte de Caparica, Portugal
| | - Joaquim J Ferreira
- CNS-Campus Neurológico Sénior, Torres Vedras, Portugal.,2Instituto de Medicina Molecular, Lisbon, Portugal.,4Laboratory of Clinical Pharmacology and Therapeutics, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
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