Monday, 24 September 2018

Assure patient safety in the heat


There is good evidence that dehydration in the summer months causes a significant increase in the incidence of urinary tract infection (UTI) and other severe infections associated with it. Jennie Wilson, the member of the Infection Prevention Society, provides these key facts to help you prevent your patients from becoming dehydrated.
Keep drinking
Adults need to take in a minimum of 1.5 liters of fluid every day. This is equivalent to at least 8 large cups or mugs of fluid.  Make sure that drinks are offered to patients enough times during the day to enable them to drink this amount of fluids
Older people are more vulnerable to dehydration
The loss of thirst reflex decreases in muscle mass in which to store fluids, and reduced kidney function combine to make older people at much greater risk of dehydration. They need to be reminded to drink and advised of the importance of drinking enough to keep them healthy
Any fluid is good fluid
The most important thing is to consume sufficient fluids; it does not matter what form this takes. Use fluid-rich foods such as jelly, ice cream, yogurt to supplement fluids in drinks
Assistance to drink
Think about the design of cups or mugs used to serve drinks. Are these appropriate and pleasant for patients to hold and drink from?  Remember that some older patients may need someone to help them drink and a member of staff will need to be allocated to support them
Support people worried about incontinence
One reason older people do not drink enough is that they are worried about being able to get to the toilet in time or about getting up in the night to use the toilet. Make sure that they know how important it is that they drink enough during the day. If they are in hospital or care, ensure they are reassured that they can ask for help to get to the toilet
Look out for signs of dehydration
Some of the more obvious signs are a dry skin or mouth, dark-colored urine, or complaining of a headache.  Also look out for confusion or drowsiness as these can also be important indicators that a patient is becoming dehydrated
Choice and drinks preferences
Exploring preferences of your residents and extending the choice of drink to include theirs can make a big difference. Introduce an anonymous form to help residents select what they enjoy drinking the most
Introduce protected drinks time
A structured approach to ensuring all residents are offered drinks means no confusion as to who has or hasn’t had a drink most recently
Provide additional drinks before and after meals
Some people may not manage to drink with their meal or may not want to. Building in extra time for hydration around the meal means that the need for drinking won’t get lost when the focus is on food
These principles are not only important for patients in the hospital, but also for the frail elderly in their own home or in residential care

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