We invited Katie Lean, Patient Safety Manager at Oxford AHSN/Oxford Patient Safety Collaborative, to talk to us about the Good Hydration! Initiative which raises awareness of the importance of hydration with care home staff and residents.
Dehydration is a common problem in many care homes. It increases the risk of falls, urinary tract infections (UTIs), acute kidney injury (AKI) and sepsis among residents. UTI is a common cause of emergency hospital admission.
The Oxford Patient Safety Collaborative (PSC) and East Berkshire CCG have been working in partnership with care home staff and residents to raise awareness of the importance of hydration and good UTI management.
Through the Good Hydration! initiative care home staff were given training on the anatomy of the urinary system, the importance of hydration and the consequences of dehydration with the help of animated videos and an online quiz.
The training also included how to identify a UTI using national guidance and NICE quality standards. Care home staff started recording UTI symptoms on a form which promoted better communication with GPs, including the agreed treatment plan and details of any antibiotic prescribing.
To improve hydration, care home staff initiated an easy-to-implement system of seven daily drinks rounds. Residents were encouraged to decorate drinks trolleys and create personalised drinks and cups. The drinks rounds were stimulating and appealing to older people and those with dementia and they became a focal social point in many care homes.
The Good Hydration! initiative led to a 36% reduction in UTIs in care homes requiring hospitalisation and a 58% drop in UTIs needing antibiotics. The time between UTIs increased from an average of nine days in the initial baseline period to 80 days during the implementation and sustainability phases. One care home in East Berkshire recorded no UTIs for 243 days. The reduced need for prescribing antibiotics also helped minimise risks around antibiotic resistance and also freed up GP time.
Involving care homes from the start was crucial to the success of this initiative. Regardless of their individual role, everyone can play a part in improving safety and quality of care for older people.
This project has been recognised in many national awards and published in the BMJ Open Quality (July 2019). All resources to set up and run a Good Hydration! project can be found on the website of the Oxford PSC (which is part of the Oxford Academic Health Science Network – AHSN).
For further information please contact; Katie Lean, Patient Safety Manager, Oxford AHSN/Oxford Patient Safety Collaborative