Components of a Comprehensive hydration program

Follow these guidelines for development and maintenance of a Comprehensive Hydration Program in your nursing home facility.

Signifies downloadable items available on the LTC Institute web site,

  1. Educate staff and families on the warning signs for dehydration and on the action steps to prevent dehydration.

Nutrition Care Alerts education materials

  1. Estimate each resident’s fluid needs upon initial, quarterly, annual and significant change assessments.

ADA’s Nutrition Risk Assessment

  1. Develop and maintain a comprehensive care plan that documents the resident’s dehydration risk factors, estimated fluid needs and an individualized plan for meeting fluid needs.

Use Investigative Protocol for Hydration as a reference for risk factors.

  1. Establish a facility standard for the minimum amount of fluid served on meal trays each day and assure that residents receive adequate assistance at mealtime.

How-To Guide for Interdisciplinary Dining Program

  1. Provide a large water cooler at each nursing station and replenish with fresh cool water daily. Make sure that 10–12 oz cups are readily available (cup holders may be needed). Develop a procedure for how coolers are washed and sanitized.
  1. Use 8oz cups to provide fluids at each medication pass.
  1. Start systematic fluid passes by using a hydration cart at least twice daily and offer a variety of fluids. Use 10 -12oz cups and include fluid selections that are new for residents, such as tropical punches, caffeine free sodas and ethnic beverages that are favorites for your resident population.

Food and Hydration Aide Staff Position

Hydration Cart Policy and Procedure

  1. Set up hydration stations in the Rehabilitation and Activities Departments.
  1. Implement a visual system, such as a picture of a drop of water next to the resident’s name on his/her door, so that staff can easily identify residents at highest risk for dehydration.
  1. Implement a mealtime and between meals fluid intake documentation system.

Validated Method for Documenting Food and Fluid Intake at Meals

Overview and Instructions for Tracking Fluid Between Meals

  1. Establish a system for providing the facility’s Registered Dietitian (RD) and/or Diet Technician (DTR) with a copy of current hydration related laboratory values. The RD and/or DTR review the laboratory results, complete a timely assessment of the resident’s hydration status and update the resident’s hydration plan of care as needed.

Signs and Symptoms of Dehydration Checklist

  1. Implement quality assurance monitoring of the Comprehensive Hydration Program.

Quality/Performance Improvement Monitor for Food/Fluid Intake

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