Abstract

Good nutrition is a recognised outcome in the health and well-being of older care home residents and dysphagia is a known risk factor associated with under nutrition and poor outcomes. The study co-produced a digital Dysphagia Guide with Care Homes using a consensus method with interviews and focus groups to prioritise the need for information and explore acceptability of an educational tool for care home workers. Evaluation of use, acceptability of design, and content of the guide were completed via remote monitoring. The workforce prioritised the need for training as well as the knowledge and skills in relation to planning resident-centred care and advice on textured diets. The technology was a means of offering ‘bite-size’ learning to enhance planning for nutrition across the whole organisation including managers, kitchen staff, and care workers. The Guide to Dysphagia was produced on a tablet and piloted in four care homes over 12 weeks, by 57 staff. Integrated analytics allowed user activity to be monitored. Findings showed that 73% of respondents reported the guide helped them in their job. Additionally, 88% of respondents stated they would recommend the guide to other staff, with 90% reporting it was easy to use. Engagement with staff and managers in four homes resulted in a co-designed, dysphagia guide.

Highlights

  • The World Gastroenterology Global Guidelines 2014 [1] estimate that dysphagia that results from a range of medical conditions, such as stroke or degenerative conditions, affects more than 51% of institutionalized elderly patients

  • Our findings show that e-learning is used within the care homes to provide education and training for staff

  • A digital dysphagia guide was co-designed with care home staff to provide a knowledge resource for organisations, managers, and care workers, increase knowledge, confidence, and skills in supporting their residents with dysphagia, and to use best practices aligned with the international standards of evidence for dysphagia management

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Summary

Introduction

The World Gastroenterology Global Guidelines 2014 [1] estimate that dysphagia (swallowing difficulties) that results from a range of medical conditions, such as stroke or degenerative conditions, affects more than 51% of institutionalized elderly patients. Over 1.47 m care workers are providing support to individuals with dysphagia who are residing in nursing or residential care settings [3]. Person-centered care can contribute to quality of life and well-being of nursing home residents, relatives, and staff. When nutrition and hydration are well managed, i.e., providing a customized diet and consideration of the individual’s nutritional needs, it makes a vital contribution for people recovering from illness and for those at risk of malnutrition. It poses a significant threat to patient safety [5].

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