I-Hydrate: A service improvement project to improve the hydration of elderly care home residents

North West London
Start Date: 1 Sep 2015 End Date: 31 Mar 2017

I-Hydrate: A service improvement project to improve the hydration of elderly care home residents

Frail, dependent, care home residents are especially vulnerable to dehydration. This is in large part due to physical or cognitive impairments, and the organisation of care in these challenging environments. Dehydration is a significant problem among older people, which has adverse effects on their health and can result in admission to hospital.  I-Hydrate aims to optimise the hydration of residents and increase the number of residents consuming their daily target fluid intake.

This project is based in in two care homes in West London. The project team comprises nurses and healthcare assistants from the care homes, researchers from the University of West London, and clinicians from the CCG collaborative.

Initial activity has involved observing the current processes for delivering fluids and key barriers to hydration of residents. This has helped identify opportunities for improving residents’ hydration, including altering existing routines to increase the fluid delivery opportunities, enhancing mechanisms for recording and acting on low fluid intake, and identifying resident preferences and equipment to support their drinking.  These findings have informed the development of an Action Effect Diagram (Reed, McNicholas, Woodcock, et al., 2014) and forms the basis of the improvement activity in the next phase of the project. Systems have been established to collect baseline data on fluid intake and hydration linked health events, such as urinary tract infections, in order to evaluate the impact of the improvement activity.

This project is particularly exciting because it is located in an extremely important, but poorly researched, care setting where most staff have limited training and are unfamiliar with research and quality improvement initiatives.

The learning that will be gained from I-Hydrate has the potential to improve the health, well-being and quality of life of care home residents by demonstrating the impact of small, structured changes to the organisation and delivery of care.

Jennie Wilson