Perceived quality of collaboration in dehydration care among Dutch nursing home professionals: A cross‐sectional study

Abstract

Aim To explore the perceived quality of collaboration in dehydration care among nursing and medical staff in Dutch nursing homes. Design A cross‐sectional study. Methods An online questionnaire was administered to nursing and medical staff in February 2020 to assess the quality of collaboration in dehydration care and its influencing factors. Descriptive statistics, chi‐square tests and multinomial logistic regression analysis were used to describe the results and examine differences between groups. Results In total, 695 questionnaires were completed by multiple levels of (specialized) nursing staff and nursing home physicians. The quality of collaboration was assessed as good (23.2%), sufficient (59.4%) and insufficient (17.4%). Predicting factors related to perceiving the quality of collaboration as good were working experience, dehydration training during education and the presence of a dehydration protocol/guideline in the nursing home. Enabling factors related to collaboration in dehydration care were ‘availability of sufficient aids to detect dehydration’, ‘continuity in the care relationship’ and ‘sufficient background data of the resident in the care record’. Factors that hinder collaboration were ‘insufficient knowledge about dehydration among nursing and medical staff’, ‘the absence of a team meeting in which the topic dehydration is discussed’ and ‘insufficient staffing level among nursing and medical staff’. Conclusion Collaboration in dehydration care was generally assessed as sufficient. Participants with >10 years of working experience, who received dehydration training during their education and had a dehydration protocol/guideline available in the nursing home, perceived the quality of collaboration more often as good. Experienced barriers and enablers for collaboration in dehydration care varied between professional groups. Therefore, it is important to gain more insight into (informal) caregivers’ perceptions on what is expected from each other about dehydration care. Impact Care professionals experience several limiting factors in collaborating in dehydration care. Addressing these factors could optimize dehydration care in Dutch nursing homes.

Dehydration in the nursing home

“…24,52 Thirteen studies (68%) were assessed as having moderate quality (14-20 points). 8,9,[40][41][42][43][44][45][46]48,50,51,53 Lastly, four studies (21%) had a low quality (13 points or less). 47,49,54,55 29…”

“…The studies were executed between 1984 and 2016. The majority of the studies (n=9) had a cross-sectional study design 24,[40][41][42][43][44][45][46][47] and most studies were performed in the United States (n=8). 8,9,40,41,[48][49][50][51] The number of study participants ranged from 16 to 790,048.…”

“…The majority of the studies (n=9) had a cross-sectional study design 24,[40][41][42][43][44][45][46][47] and most studies were performed in the United States (n=8). 8,9,40,41,[48][49][50][51] The number of study participants ranged from 16 to 790,048. This large range is caused by the differences in study design, ranging from small-scale observational studies to large retrospective studies using data from databases.…”

“…Most studies (n=7) based their operationalization of dehydration on blood tests, in which the majority used serum sodium (S na ) and/or serum osmolality (S Osm ) as leading markers. 8,9,24,41,42,44,46 Prevalence rates per method of operationalization for dehydration were 17.1%-38.3% for blood testing (n=7) 8,9,24,41,42,44,46 , 8.3%-38.5% for physical examination (n=3) 48,51,52 , 25% for urine testing (n=1) 54 and 34.7% for a combination of blood and urine tests (n=1) 53 Finally, the prevalence rates in the studies in which the operationalization of dehydration was not described (n=4) varied between 0.8%-10.6%. 43,45,49,50 Risk factors for dehydration Fourteen studies examined the possible risk factors for dehydration among nursing home residents.…”

“…44,46,48,53 The remaining studies (n=7) did not specify with which type of dehydration (i.e., chronic or acute) the potential risk factors were associated with. 24,[40][41][42][43]45,47 The most frequently investigated risk factor was gender (n=4). Three out of four studies 8,24,44 found a significant relationship between gender and dehydration whereas one study did not.…”