An award-winning hydration nurse specialist is urging health and care providers to trial a simple risk assessment tool that has been shown to significantly reduce hospital admissions from care homes.
Naomi Campbell, chair of the National Hydration Network and developer of the tool, said her system could help limit stressful hospital visits for frail, older residents and ease pressure on hard-pressed hospitals and cut NHS costs.
“It identified and raised awareness of a resident’s potential risk of dehydration”
Her call follows an independent evaluation of the tool – called the Reliance on a Carer to Drink Dehydration Assessment Tool (ROC) – that found it had helped reduce acute hospital admissions for urinary tract infections and falls.
The tool uses a traffic light system to assess individuals’ support needs when it comes to three key aspects of hydration care – ability to swallow, whether they need help to safely hold a drink to their mouth and whether they need encouragement to drink.
A red, amber or green rating is then used to identify whether a resident requires a high, medium or low level of care for each of these areas, which is subsequently reflected in their care plans.
Ms Campbell created the tool while working for Peninsula Community Health Community Interest Company, which funded her to establish the Simple Measures not-for-profit social enterprise to develop ROC and other innovations in hydration care.
An evaluation of the ROC tool by the Kent Surrey Sussex Academic Health Science Network, published this spring – as part of a wider evaluation of the Hydrate in Care Homes project – found it had helped reduce hospital admissions.
All participating homes tested various measures to improve hydration care. Those who used the ROC tool saw an 85% greater reduction in admissions to hospital due to urinary tract infections compared to those that did not.
Homes that used the tool also saw a 22% greater reduction in admissions for falls and a 9% greater reduction in admissions due to fractured neck of femur.
Hydration leads – or champions – from 18 homes in total gave their feedback.
“Overall results were very positive, with all champions feeling that the tool was a standardised, quick and easy way to assess how much basic support an individual needed to safely drink,” stated the evaluation report, published in April.
“They also all felt that it identified and raised awareness of a resident’s potential risk of dehydration,” it said. “The positive results were reflected in fact that all stated that they would opt to continue to use the screening tool and care plan summary after the end of the project.”
Nurse innovator urges adoption of hydration risk tool
Ms Campbell, named “nurse innovator of the year” by the British Journal of Nursing for her work on ROC and other practical hydration resources, has since written to commissioners and health and social care providers urging them to take part in wider trials of the tool.
Organisations can access the tool and other resources through membership of Simple Measures at a minimal cost of £5 per person per year. The company also provides training on using the tool.
Other resources in the pipeline include a new simple-to-use system of monitoring those at risk of dehydration, designed to ensure concerns are escalated and acted upon, which should be available this autumn.
Meanwhile, the National Hydration Network, an expert group of healthcare professionals and researchers formerly hosted by NHS England and now hosted by Simple Measures, is seeking support to develop a “health economic hydration care model”.
“This model will be used to influence future research, quality improvements, staffing levels and re-allocation of resources to ensure sustainable and cost-effective best practice in care homes, hospitals and the community,” said a letter to commissioners and providers (see attached PDF below).
The network is asking organisations to submit formal expressions of interest in supporting further work to spread best practice in the field of hydration care.