Abstract
BackgroundEvidence has shown a relationship between dehydration, falls, and pulmonary aspiration among older adults in nursing homes, all of which contribute to loss of independence and quality of life. It is believed that improving communication among healthcare professionals in nursing homes (physicians, nurses, rehabilitation team, psychologist, social workers, dieticians and medical assistants) decreases the number of adverse events in institutionalized patients. This study will evaluate the feasibility of using a set of written signs, designed to caution against the risk of falls, dehydration, and pulmonary aspiration, and will enable the proposal of tailored interventions to manage these events in nursing homes.Methods/DesignAll patients from Campus Neurológico Sénior (CNS) nursing home, at risk of falls and/ordysphagia and/or dehydration will be invited to participate in the study. Patients will undertake a screeningrisk assessment and the corresponding risk prompts will be attributed. Study duration will be a minimum ofthree months per participant, including daily record of falls, dehydration and pulmonary aspiration eventsand monthly interview assessments, conducted by a member of the research team. Data of the events that occur will be compared with historical data extracted retrospectively from medical and nursing charts. This study has been approved by the Ethics Committee of the Medical Academic Center of Lisbon, Faculty of Medicine, University of Lisbon (Ref. 176/15). All participants will give their written informed consent before entering the study.DiscussionThis study is unique in evaluating the feasibility of a communication system in preventing the three major risks in nursing home. Thoughtful selection and display of proper risk prompts in nursing homes could be an essential step along a path toward efficient communication of risks among healthcare teams. We expect that the displays will be easily applicable given their simplicity, low complexity, and minimal physical requirements.Trial registrationNCT03123601. March 7, 2017. Retrospectively registered.
Highlights
Evidence has shown a relationship between dehydration, falls, and pulmonary aspiration among older adults in nursing homes, all of which contribute to loss of independence and quality of life
The aim of this study is to develop and evaluate the feasibility of a set of risk prompt displays to communicate the risk of falls, dehydration, and pulmonary aspiration and to reflect on tailored interventions that would appropriately manage these events in nursing homes
Thoughtful selection of proper risk prompt displays in nursing homes is an essential step along a path toward efficient communication of risks among teams
Summary
Evidence has shown a relationship between dehydration, falls, and pulmonary aspiration among older adults in nursing homes, all of which contribute to loss of independence and quality of life. Dehydration, due to poor fluid intake or pathologic loss of body fluids, is considered to be present in 0.8 to 1.4% of nursing home residents It is associated with frailty, poor cognition, falls, delirium, disability, and mortality and is a major cause of decreased attention and fluctuating mental status, the hallmarks of delirium, in the nursing home [12]. To provide high-quality care and prevent these risks, nursing home multidisciplinary team members (i.e., physicians, nurses, professionals from rehabilitation team, psychologists, social workers, and medical assistants) need to work as a coordinated team, have an effective system of communication with access to information, and understand the residents’ needs [13, 14]
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