The Implementation of an Innovative Hydration Monitoring App in Care Home Settings: A Qualitative Study (Preprint)

Abstract

The implementation of an innovative hydration monitoring App in care home settings: a qualitative studyBackground In response to significant concern regarding inadequate fluid intake recording in care homes, an innovative mobile hydration application was collaboratively developed. 'Hydr8' aimed to facilitate accurate recording and communication of residents' fluid intake and ultimately increase care quality and patient safety.Objective The aim of this study was to examine the implementation of Hydr8 in a sample of care homes within one area in England.Methods Principles of Realist Evaluation and Action research were drawn upon throughout. Five care homes participated; three interview-only sites and two case-study sites, where interviews and observations were conducted at three time points. Twenty-eight staff participated including care staff, management, a registered nurse and administrative staff.Results Findings suggest Hydr8 benefited practice: enhancing understanding of hydration and person-centred care, and improving staff communication.However, technical glitches hindered the seamless embedding of Hydr8 into everyday practice and enthusiasm for long-term use was dependent on resolution of issues. Hydr8 also heightened perceptions of personal accountability and while managers viewed this as positive, some staff were apprehensive. However, individuals were enthusiastic about the long-term use and potential of Hydr8.Conclusions Utilising the findings from this study to further develop and adapt Hydr8 indicates the long-term use of Hydr8 as promising. Perceptions of Hydr8 were primarily positive, however, setbacks in its implementation and use created difficulties in normalising the solution into everyday practice. This study highlights the need for education relating to hydration practice and a change of infrastructure in care home settings in order to implement technical solutions and changes to care.