Proposed Topic (Most preferred): :
Clinical Safety and Quality Service II (Projects aiming to enhance clinical safety and outcomes, clinical governance / risk management)
Proposed Topic (Second preferred): :
HA Young Investigators Session (Projects to be presented by HA staff who had joined HA for 10 years or less)
Authors (including presenting author) :
WONG MM(1), HUNG TT(2), HO PC(2), LAM WT(3), YEE WS(4), AU KY(2)
Affiliation :
(1) Department of Orthopaedics and Traumatology, (2) Department of Medicine, (3) Department of Oncology, (4) Nursing Services Division, Pamela Youde Nethersole Eastern Hospital
Introduction :
Dehydration poses a significant health risk for the elderly with dysphagia. Unidentified dehydration of the elderly can lead to increased morbidity, mortality, and unnecessary hospital admissions. Early detection and intervention of dehydration in the community are crucial in preventing complications and unnecessary admission during community visits by healthcare teams. In Hong Kong, there is no standardized non-invasive dehydration screening tool for assessing and managing elderly dehydration in the community. To address this gap, a new non-invasive screening tool, called the Dehydration Assessment Tool in Elderly (DATE), was developed in December 2023. The tool incorporates various clinical indicators, including vital signs, subjective symptoms (Feeling of dry mouth, habit of drinking water between meals) and objective assessment (Inspection of tongue dryness, sternum skin turgor, urine colour, intake and output balance and diuretics administration). It aims to enhance nurses’ early detection and timely management of elderly dehydration in the community.
Objectives :
(1) To develop a practical, rapid, and non-invasive dehydration screening tool tailored for elders aged 60 years or older in the community and (2) To evaluate the reliability and validity of the non-invasive screening tool in detecting dehydration.
Methodology :
(1) Extensive literature review to identify validated non-invasive indicators of dehydration. (2) Review CVI of the screening tool by the multidisciplinary expert panel in geriatric healthcare services. (3) Measuring reliability by Cronbach's Alpha indicates internal consistency.
Result & Outcome :
121 pieces of literature were reviewed, and 8 articles graded quality of evidence IIB or above were synthesized, leading to the development of a 13-item screening tool. The computation of Cronbach's Alpha for the newly developed screening tool yielded a value of 0.66, which indicates acceptable reliability. The I-CVI ranges from 0.56 to 1, indicating variability in expert evaluations. The S-CVI-Ave, calculated at 0.812, represents the average agreement across all items.
Conclusion:
The non-invasive dehydration screening tool demonstrated high reliability and internal consistency in quick and straightforward detection of dehydration status promptly in elderly with dysphagia, ultimately improving patient outcomes and reducing the burden of dehydration-related hospitalization in this population. The Diagnostic performance would be further reviewed by the ROC curve with Blood Urea Nitrogen (BUN) ratio in future studies.
