My heart sank as I received a text message from a dear friend. “Grandpa is in hospital with sepsis. He was vomiting, high temperature with pus around his catheter.” The next day my friend informed me Grandpa was \u201con IV antibiotics and slowly coming round, but he’s not out of the woods yet.\u201d<\/p>\n
This\u00a0Grandpa was admitted to hospital from a nursing home, and\u00a0this nursing home was 300 miles from my ‘patch’.\u00a0 But oh, how familiar the scenario was.\u00a0One of the most common reasons for hospital admission from care\u00a0homes is a UTI. By the time the patient is admitted many\u00a0are well on the way to having acute kidney injury. \u00a0This is distressing for the individual, their family and staff as well as being costly to the NHS.\u00a0I believe many of these UTIs could be prevented, and the place to start is hydration.<\/p>\n
Part of our quality monitoring within Birmingham Cross City CCG homes, we ask the question \u201cis the fluid balance chart up to date and accurate?” then a follow up question “is poor fluid intake recorded and escalated?”<\/p>\n
Our results\u00a0have found at least 80% of our homes have needed support in documenting an accurate record of fluid intake, and encouragement in knowing how to effectively escalate or highlight when residents have received a low fluid intake. Which\u00a0is why I was pleased to be part of a working group with the Think Kidneys programme\u00a0to explore the design of some resources specifically promoting hydration and education in care homes.<\/p>\n
Nursing homes are in a unique\u00a0position because they are classed as community based, \u00a0have nursing input,\u00a0yet at the same time they\u00a0have to wait for primary care consultations just as any member of the public! Nurses in nursing homes often don’t have the same access to training or resources as hospital based nurses, and certainly don’t have the access to frontline medical interventions as hospitals do, so\u00a0considering the \u2018Sheffield surgical care resources\u2019 as an\u00a0educational tool\u00a0for nurses in\u00a0nursing homes is inappropriate.\u00a0The Think Kidneys team is now in the process of addressing that problem, by designing a care home specific education tool. This should be invaluable in highlighting the value of hydration and continence care in a nursing or residential home setting.<\/p>\n
Anecdotally we know good things come from such education and emphasis. When we returned to a large home following a quality monitoring visit that had originally found poor fluid charts; we were told that the manager had emphasised the need to both encourage fluids, to document fluid intake accurately, and to escalate any poor fluid intake to the rest of the team. On inspection of the new charts, we found she had done a good job of ensuring timely documentation. As a result of timely documentation, the residents were being encouraged to drink more, which was seen in the evidence of increased fluid intake since our previous visit. Any reduced fluid intake had been documented and highlighted to the following shift. Nurses had been tasked in ensuring regular monitoring of the charts, and it had been successful.<\/p>\n
So it wasn\u2019t a great surprise when the home manager informed me at the end of our visit, that since the increased emphasis on hydration and fluid accuracy had been implemented, the nursing home had not had any incidents of UTIs among their residents. Not a coincidence, but a positive outcome from a simple intervention to encourage and document fluid intake.<\/p>\n
My friend\u2019s Grandpa is now well and back in his care home. Let us look out for all the grandpas and grandmas out there by being informed and enthusiastic around the Think Kidneys agenda.<\/p>\n","protected":false},"excerpt":{"rendered":"
My heart sank as I received a text message from a dear friend. “Grandpa is in hospital with sepsis. He was vomiting, high temperature with pus around his catheter.” The next day my friend informed me Grandpa was \u201con IV antibiotics and slowly coming round, but he’s not out of the woods yet.\u201d This\u00a0Grandpa was admitted to hospital from a nursing home, and\u00a0this nursing home was…<\/p>\n","protected":false},"author":114,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_bbp_topic_count":0,"_bbp_reply_count":0,"_bbp_total_topic_count":0,"_bbp_total_reply_count":0,"_bbp_voice_count":0,"_bbp_anonymous_reply_count":0,"_bbp_topic_count_hidden":0,"_bbp_reply_count_hidden":0,"_bbp_forum_subforum_count":0,"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":false,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"enabled":false},"version":2}},"categories":[1],"tags":[],"class_list":["post-2570","post","type-post","status-publish","format-standard","hentry","category-blog"],"acf":[],"yoast_head":"\n