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A multicentre prospective audit of bedside hydration in hospital

09 January 2020
Volume 29 · Issue 1

Abstract

Introduction:

access to water at the bedside is a cornerstone of patient care. Among bedbound inpatients, water within reach at the bedside is a basic human dignity and one that ought not to be neglected.

Aim:

the authors sought to identify the extent to which accessible hydration facilities were provided to a bedbound inpatient population.

Methods:

a cross-sectional, point-prevalent audit of hospitalised medical inpatients across five centres was conducted. Data were collected between meal times and noted baseline demographics and admission details, adequacy of oral hydration provision at the bedside and, where provision was inadequate, factors associated with this.

Results:

across a total surveyed patient population of 559 we identified 138 patients who were bedbound. Among these bedbound patients, 6% (n=8) had no water provided at the bedside. However, 7 of these were deemed to be unable to swallow safely. In total, 44 (32%) of the 138 bedbound patients were unable to reach the water at their bedside; 18 of these patients would have been able to drink for themselves had the water been in reach.

Conclusion:

there is significant room for improvement in ensuring patients who are immobile are able to reach drinking apparatus at the bedside. In the five centres surveyed, approximately one in five bedbound patients with no contraindication are unable to reach an essential means of hydration.

The importance of adequate hydration for the maintenance of good health and wellbeing is widely recognised and is publicly advocated in the UK (Popkin et al, 2010; NHS website, 2018; 2019). Recent reminders in the published literature inform clinicians of the marked improvements in personal performance attained by adequate hydration (Parry et al, 2017). Patient malnutrition in the hospital setting, a known predisposing risk factor for morbidity and mortality, has received a significant amount of focus in recent literature, with both academic and political publications describing this as a clear issue within the UK health system (Brotherton et al, 2010; Parliamentary and Health Service Ombudsman (PHSO), 2011; Leach et al, 2013; Stratton et al, 2018).

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