Evaluation of the Staff Educational Components of the PROMOTE Program to Improve Resident Hydration.

Background/objectives: Inadequate fluid intake is prevalent among older adults living in care settings and can lead to dehydration-related events such as falls and hospitalization. Staff knowledge and confidence using diverse strategies is needed to provide adequate hydration to residents. PROMOTE is a multicomponent intervention designed to support staff to increase resident fluid intake between meals.

Qualitative analysis of a virtual research meeting summarises expert-based strategies to promote hydration in residential care during COVID-19 and beyond.

Objectives: Poor fluid intake is a complex and long-standing issue in residential care, further exacerbated by COVID-19 infection control procedures. There is no consensus on how best to prevent dehydration in residents who vary in their primary reasons for insufficient fluid intake for a variety of reasons. The objectives of this research were to determine expert and provider perspectives on: (1) how COVID-19 procedures impacted hydration in residential care and potential solutions to mitigate these challenges and (2) strategies that could target five types of residents based on an oral hydration typology focused on root causes of low fluid intake.

Feasibility and Acceptability Testing of Evidence-Based Hydration Strategies for Residential Care.

The current study examined stakeholder perspectives on the perceived effectiveness, feasibility, and acceptability of 20 evidence-based strategies appropriate for residential care via an online survey ( = 162). Most participants worked in long-term care (83%), were direct care providers (62%), worked in food/nutrition roles (55%), and identified as female (94%). Strategies that were rated as effective, feasible, and likely to be used in the future were social drinking events, increased drink options at meals, and pre-thickened drinks.

Evaluation of the Montessori-Inspired Lifestyle as the Foundation of Care in Assisted Living Memory Care.

The Montessori-Inspired Lifestyle (MIL) was implemented as the foundation of care in several assisted living memory care (ALMC) neighborhoods to enhance meaningful social roles, engagement, and focus on residents' remaining capabilities. The purpose of this quality improvement project was to evaluate the outcomes regarding resident levels of engagement and prescribed antipsychotic medications before and after MIL implementation. A total of 85 residents were observed for 10-minute periods seven times during 1 day to ascertain the level of engagement during meals and planned and unplanned activities.

Hydration Management.

Optimal hydration is essential to health, yet many common health problems of older adults are exacerbated by suboptimal hydration, including falls, adverse medication events, and urinary tract infections to name a few. Understanding dehydration in older adults is difficult, and causes for inadequate intake are multifocal. The current article provides important care guidelines on assessing risk and providing essential interventions to prevent dehydration.

Feasibility and Usability of Salivary Alpha-Amylase to Measure Stress Among Individuals With Dementia.

Salivary alpha-amylase (sAA) is a noninvasive biomarker of the sympathetic-adrenal-medullary system and reflects stress. The purpose of the current study was to determine the feasibility and meaningfulness of the use of sAA levels for assisted living memory care (ALMC) residents. Participants were 10 ALMC and eight independent/assisted living (I/AL) residents.

Hydration Status of Assisted Living Memory Care Residents.

Water intake and hydration status of assisted living memory care (ALMC) residents were evaluated. Thirty-two residents (eight men; mean age 86.5 years; Global Deterioration Scale [GDS] 3 to 7) from four ALMC units participated.

Progress and Changes in Gerontological Nursing Research in the Midwest: A Review.

Gerontological nursing has a rich research history. The current article reports trends in gerontological nursing research found through review of abstracts of presentations at the Midwest Nursing Research Society annual conference at 10-year increments over the 40-year existence of the organization. Researchers studied a wide range of topics, from quality of life to use of technology, with a variety of older adult populations represented.

Establishing a Collaboration Contract to Facilitate Team Performance.

Effective collaboration is essential for team projects whether related to research, evidence-based practice, or quality improvement efforts and is especially relevant to the doctor of nursing practice (DNP)-prepared nurse (American Association of Colleges of Nursing [AACN], 2006). High-quality projects are accomplished through planning and organization and cannot be left to chance (Yonge, Skillen, & Henderson, 1996). A collaboration contract negates the "left to chance" philosophy by promoting clarity of roles, responsibilities, and team processes.

Clinical symptoms, signs and tests for identification of impending and current water-loss dehydration in older people.

Background: There is evidence that water-loss dehydration is common in older people and associated with many causes of morbidity and mortality. However, it is unclear what clinical symptoms, signs and tests may be used to identify early dehydration in older people, so that support can be mobilised to improve hydration before health and well-being are compromised.

Objectives: To determine the diagnostic accuracy of state (one time), minimally invasive clinical symptoms, signs and tests to be used as screening tests for detecting water-loss dehydration in older people by systematically reviewing studies that have measured a reference standard and at least one index test in people aged 65 years and over.

A longitudinal study of the health status of a community of religious sisters: addressing the advantages, challenges, and limitations.

Longitudinal studies are recognized as contributing to understanding the complexity of aging and generating insights that cannot be gained using other research methods. However, conducting longitudinal studies is recognized as challenging, especially among older adults. The purpose of the current review is to describe how the authors addressed the limitations and challenges of longitudinal studies in a study of the health status of a community of religious sisters.

Implementation of an epilepsy self-management protocol.

It is essential that patients with epilepsy receive educational information about their disease and its management, but there is dissatisfaction with the education received. The purposes of this evidence-based project were to examine the current knowledge level and disease management behaviors of patients with epilepsy in an outpatient clinic and to measure the effectiveness of implementing a self-management protocol using the Epilepsy Self-Management Scale (ESMS). Pender's health promotion model and Rogers' diffusion of innovation theory were used to guide the development and completion of this project.

Implementation of a baby doll therapy protocol for people with dementia: Innovative practice.

Dementia is exhibited by both emotional and physical states such as agitation. Chemical restraints, often used for agitated behaviors, are not always effective and produce untoward effects. Baby doll therapy is a nonpharmacologic therapy that can affect agitated behavior in dementia patients, yet a protocol for the therapy did not exist.

Effect of a long-term care geriatrics rotation on physician assistant students' knowledge and attitudes towards the elderly.

Physician assistants (PAs) have the opportunity to contribute to the high demand of providing health care to the growing older adult population. It is essential they have the knowledge to meet this need. The purpose of this study was to determine the difference in knowledge of and attitudes towards the elderly among a group of PA students before and after a required four-week geriatric rotation.

Implementation of a self-care of heart failure program among home-based clients.

Heart failure is the most common admission in hospitals among Medicare recipients aged 65 years or older. Self-care management of heart failure has been reported to decrease heart failure hospital admission rates. The purpose of this evidence-based practice project was to examine how a self-care of heart failure program (Heart Failure Self-care to Success) impacts hospital admissions and patient perceptions of self-care management.

Designing a protocol to reduce catheter-associated urinary tract infections among hospitalized patients.

Hospital-acquired urinary tract infections comprise 40% of hospital-acquired infections with over 80% of these hospital-acquired urinary tract infections associated with the use of urinary catheters. The process that was used to establish a new hospital protocol using the "IAIMS" (identifying, assessing, implementing, modifying/maintaining, spread/surveillance) model to reduce the incidence of catheter-associated urinary tract infections is described. The example is intended to serve as a framework for the development of protocols to address other hospital-acquired infections.

Comparison of four standards for determining adequate water intake of nursing home residents.

Adequate hydration for nursing home residents is problematic. The purpose of this study was to compare four standards used to determine a recommended water intake among nursing home residents. Inconsistencies in the amount of water intake recommended based on the standards compared were identified.

Patient functional status changes during hospitalization: impact on early discharge planning.

Purpose/objectives: The purpose of this study was to inform the discharge planning process by determining differences in functional status from admission to discharge of adults hospitalized for either medical or surgical reasons.

Design: The study design was a secondary analysis of data originally collected for a discharge planning study.

Sample/setting: The primary study included 304 adult patients hospitalized at 2 hospitals in a large midwestern healthcare delivery system.