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'How difficult can it be to take a glass of water, put it to a patient’s lips and get them to drink?'

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Most readers of Nursing Times know just how difficult it can be to get patients to drink. 

It may be because the thickened fluids are unpalatable, or the water is too hot or too cold; perhaps someone forgot to put sugar in the tea or added too much but the patient cannot tell you.

“Encouraging patients to drink can be a battle of wills”

Encouraging patients to drink can be a battle of wills, with the nurse desperate to record some intake on a fluid chart and avoid the need for an IV when their patient is just not feeling up to it. All the while, family members are anxiously flipping through the charts and wondering why their relative’s fluid intake is so poor.

When the weather is as hot as it has been recently the risk of dehydration make all these anxieties worse.

Risk assessment is a vital first step in ensuring patients remain hydrated but health professionals may not have access to standardised protocols for assessing risk of dehydration.

The first article in this archive issue describes the development of a nurse-led risk assessment tool – the Northumbria Assessment of Hydration tool, which helps staff to determine patients’ risk of dehydration and plan appropriate interventions.

The authors found that after implementation there was a substantial improvement in the documentation of fluid balance, urine output, drinking ability and drinking preferences.

“This may be a useful tool to consider”

If you are struggling to prioritise care around hydration, this may be a useful tool to consider and the article is accompanied by a multiple-choice self-assessment, which you can complete as part of your continuing professional development.

Pre-operative patients may be at increased risk of dehydration during this hot weather because of ingrained rituals and routines of starving from midnight and 6am. Evidence suggests that, in most cases, patients can drink up to two hours before their operation.

The second article in this archive issue describes how a trust challenged routine practice and dramatically reduced pre-operative fasting times. It is clear that a multiprofessional approach is essential to bring about a change as it requires co-operation between different departments and disciplines.

The final article in this issue provides an important reminder about the role of the environment in transmission of infection. It focuses on the role of nurses in ensuring the environment is safe for patients and the importance of escalating concerns.

This is the second article in a three-part series looking at this important issue. In part one the authors noted that vancomycin-resistant enterococci can remain alive on a dry laboratory surface for over four years.

This fact is a salutary reminder of why environmental cleaning must be evidence-based and cannot be left to chance.

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