Utilization patterns of hypodermoclysis and association with staffing levels in long-term care: a cross-sectional...

To describe utilization patterns of hypodermoclysis in long-term care (LTC) (primary objective), and to explore institutional factors associated with hypodermoclysis use in LTC (secondary objective); as hypodermoclysis is used to manage low-intake dehydration among institutionalized older adults.

Cross-sectional multicenter study based on a single day. Data collected by questionnaire addressed to geriatricians of LTC units affiliated with the Assistance Publique-Hôpitaux de Paris, France. Descriptive statistics summarized utilization patterns of hypodermoclysis. A multivariable logistic regression was performed to explore the association between institutional factors and the likelihood of receiving hypodermoclysis.

Among 748 residents (median age: 86; 68% female), 21% were receiving hypodermoclysis, with prevalence varying significatively across centers (14-36%). Hypodermoclysis had been prescribed for a median duration of 95 days on the study day. It most commonly involved dextrose solution, prescribed at 500 mL per day. Factors independently associated with increased hypodermoclysis use included lower nursing assistant staffing, higher nurse staffing, and lower physician staffing.

Findings reveal heterogeneous use of hypodermoclysis in LTC, often at low volumes and over prolonged periods. Given the association between staffing levels and hypodermoclysis use, strengthened interprofessional engagement and collaboration may be needed to optimize hydration practices.