Dehydration in the nursing home: Recognition and interventions taken by Dutch nursing staff.
Simone J C Paulis, Irma H J Everink, Ruud J G Halfens and 2 others
PMID 34462958WHAT IT FOUND
Dutch nursing home RNs and CNAs linked most dehydration signs to dehydration, observed them themselves, and usually told the physician or advanced nurse practitioner.
They were less likely to link high pulse or low blood pressure.
Key findings
01Most RNs and CNAs associated many dehydration signs with dehydration, but over 20% said higher pulse rate and lower blood pressure never triggered dehydration thinking.
02CNAs reported observing dehydration signs themselves for 92.6% of items and RNs for 80.1%.
03Common actions were telling the nursing home physician or advanced nurse practitioner, giving more fluid, or telling a colleague CNA; for swallowing problems, 66.4% of RNs and 55.3% of CNAs said they consulted the speech therapist.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
Participants were recruited through a professional association, educational institutes and a convenience sample, and responses were anonymous, so it is unclear how evenly they represented Dutch nursing homes. The results are self-reported questionnaire answers, not observed care or resident outcomes. The questionnaire was developed for this study and checked by a 12-person panel for content and clarity; no validation against actual dehydration diagnosis is reported. The dehydration sign list came from an expert strategy based on literature and expert opinion, with no RNs or CNAs on the expert panel. Some answer options were only available for specific signs, such as contacting the dietician or speech therapist, which may have affected responses. No residents were included, so the paper does not show what happened to patients.
The easy way to misread this
Do not read these percentages as evidence that dehydration is recognized or treated effectively. They are self-reported actions by nursing staff, and no residents or clinical outcomes were studied.