Dehydration prevention in nursing home residents in rural Mississippi: a best practice implementation project

Older adults are at higher risk of dehydration due to age-related physiological and cognitive factors. They are commonly affected by hypertonic dehydration, usually caused by inadequate fluid intake.

This project aimed to promote evidence-based practices (EBPs) for dehydration prevention in older adults in a nursing home in rural Mississippi, USA.

Guided by the JBI Evidence Implementation Framework, the project used clinical audits to assess barriers and enablers of EBP compliance. Nine EBPs derived from a JBI Evidence Summary served as audit criteria. The baseline audit included a policy review, leadership interviews, and staff survey. Identified barriers informed strategies which were then implemented. A follow-up audit using the same nine criteria was then conducted. The results were compared to baseline data to assess changes in compliance with EBPs.

The baseline audit showed average compliance of 27%. Two barriers to EBPs were identified: (1) lack of staff awareness, knowledge, and training regarding hydration EBPs, and (2) inadequate resources or materials related to hydration care. A hydration protocol was created and implemented. Staff were trained and observed using the protocol. An educational pamphlet was developed for residents and visitors. Post-intervention audits showed 62% compliance, a 35% increase from baseline.

Post-audit results showed significant improvement, especially regarding residents' recommended fluid intake. Embedding the hydration protocol into standard procedures and maintaining leadership support will enhance the project's sustainability.

http://links.lww.com/IJEBH/A452.