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

INTRODUCTION: 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. OBJECTIVES: This project aimed to promote evidence-based practices (EBPs) for dehydration prevention in older adults in a nursing home in rural Mississippi, USA. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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. SPANISH ABSTRACT: http://links.lww.com/IJEBH/A452.