Delivering safe, effective nutrition and hydration care to residents with dysphagia: a theory-based approach to developing a link dysphagia practitioner
Award Number
NIHR200091Programme
Research for Patient BenefitStatus / Stage
CompletedDates
2 August 2019 -1 June 2021
Duration (calculated)
01 years 09 monthsFunder(s)
NIHRFunding Amount
£159,495.00Funder/Grant study page
NIHRContracted Centre
The University of West LondonContracted Centre Webpage
Principal Investigator
Professor Jennie WilsonPI Contact
jennie.wilson@uwl.ac.ukPI ORCID
0000-0002-4713-9662WHO Catergories
Development of novel therapiesMethodologies and approaches for risk reduction research
Risk reduction intervention
Disease Type
Dementia (Unspecified)CPEC Review Info
| Reference ID | 185 |
|---|---|
| Researcher | Reside Team |
| Published | 12/06/2023 |
Data
| Award Number | NIHR200091 |
|---|---|
| Status / Stage | Completed |
| Start Date | 20190802 |
| End Date | 20210601 |
| Duration (calculated) | 01 years 09 months |
| Funder/Grant study page | NIHR |
| Contracted Centre | The University of West London |
| Contracted Centre Webpage | |
| Funding Amount | £159,495.00 |
Abstract
Dysphagia is estimated to affect at least 50% of nursing home residents, especially those with stroke or dementia. It significantly increases their risk of choking, dehydration/malnutrition and pneumonia. These adverse events are associated with a poor quality of life and considerable healthcare costs, antimicrobial consumption and mortality. Clinical outcomes have been linked to the consistency with which compensatory swallowing strategies are implemented. However, the staff who deliver nutrition and hydration care to care homes residents can lack knowledge of the condition and useful strategies to prevent aspiration. Specialist Speech & Language Therapists (SLT) have limited resources to support and train care home staff. Developing an experienced care worker in the care home as a Dysphagia Link Practitioner (DLP) with formal links to the Speech & Language Therapy (SLT) service would facilitate the translation of knowledge and implementation of safe and effective nutrition and hydration care for residents with dysphagia. Aim This study aims to investigate what needs to be changed in residential care homes to increase adherence to safe nutrition and hydration care for people with dysphagia; and determine the appropriateness, acceptability and potential for a DLP role to reduce adverse events by supporting staff to deliver safer nutrition and hydration care. Methods A predominantly qualitative descriptive and developmental approach will be employed in two large care homes. It will use the Theoretical Domains and COM-B frameworks to observe current dysphagia practice, compliance with dysphagia guidelines and changes required to provide safe care; and explore system issues that would facilitate or obstruct development of a DLP and required behaviour changes. Process and outcome measures that could be used to determine effectiveness in a future intervention study will be captured from resident care records. The design will allow multiple perspectives to be elicited using a number of data collection methods and therefore allow data to be triangulated and provide a granular description of individual, system and service user perspectives. Conclusion The results will be used to build a robust intervention, underpinned by behavioural theory, to tackle the harm caused by poor quality and unsafe care practices in providing nutrition and hydration care for people with dysphagia which can be evaluated in a subsequent application for funding.
Aims
We aim to understand how the care for people in nursing and residential care homes who have a problem with swallowing, called dysphagia can be cared for safely and effectively.