Taunton & Somerset NHS Foundation Trust was a finalist in the 2019 HEFMA Awards for its pioneering project to establish the effectiveness of Droplet to improve patient hydration. HEFMA finds out more.
Taunton & Somerset NHS Foundation Trust is proud of its patient catering achievements with a quality-driven food service that ensures nutritional support empowers the patient recovery. Teams at ward level understand the necessity of food choice and availability and the Trust believes it is vital to have the same approach for hydration. Gaining this involvement and commitment increased the enthusiasm to invite a number of colleagues from within the Trust to form The Droplet Project Team.
This multi-disciplinary team comprised: Phil Shelley, Facilities Manager; Jon Smith, Catering Liaison Manager; Kerry Trunks, Ward Senior Sister; Amanda Hall, Catering Team Leader; Emelie James, Ward Senior Sister; Suzy Cole, Nutritional Nurse Specialist; Sharon Conway, Ward Senior Sister; Dawn Paull, Senior HCA Sheppard Ward; Kelly Needham, Cleaning Senior Supervisor; and Jodie Perrin, Admin Team.
Engaging with clinical teams is vital to drive positive decision-making within hospitals. Team working of this nature instills trust in each other and commitment to a change in culture requires belief in the process, product and individuals involved. The Power of 3 approach emphasises the necessity of catering and dietetic teams being involved in a preventive role. As teams we are focused on nutrition and hydration 365 days of the year and this positive pledge needs to affect the way that clinical teams work.
Dehydration in the healthcare environment is very common, which can result in avoidable harm such as pressure ulcers, falls, urinary tract infections, acute kidney injury and sepsis. Existing drinking aids are perceived as purely functional, medicinal and can often resemble babies’ beakers. None resemble a familiar cup or mug from home. Instead of encouraging the person to drink, many of the cups acted as a deterrent as they are often chewed, stained or baby-like.
To gain suitable knowledge and confidence in the proposed change around patient hydration, the Droplet Project Team met with product designer Ellie Van Leeuwen. The aim was to secure Musgrove Park as the first hospital to use the innovation of a reminder base with a hydration mug and tumbler. Meeting the designer ensured that the team captured all safety, compliance and patient management challenges in preparation of the pilot which was planned for four wards: Sheppard, Exmoor, Conservator and Gould. These wards provided a range of challenges which only seemed to stimulate the team to further success.
Any product change, particularly those that have an impact on patient care requires the collection of suitable data. This maximises the evidence of positive experiences and the difference being made with the change. Patient fluid charts were studied, monitoring current mugs and tumblers versus the new droplet items and this showed a significant increase of 67% added fluid intake.
Awareness of hydration is key if we are to improve fluid availability and ward staff knowledge. The Light & Sound Reminder Base is ideal for people who need to be prompted to drink and the Reminder Messages/Warning Lights and Night Light supports a 24/7 ward solution for patients and staff.
This focus on hydration through the Droplet Team has brought innovation to the way that the Trust plans and aids hydration for patients – which must become a priority in the recovery plan. Patients were completely involved with staff, concerning feedback forms; highlighting the benefit of staff and visitors recognising the flashing light or hearing the reminder voice to encourage drinking regularly.
The new tumblers have brought freshness to the ward level crockery with the ward staff and cleaning teams managing the cleanliness and practical effectiveness. In the past, wards have ordered their own crockery which led to inconsistency in approach and presentation of food and drink. This collaborative approach brings suitable quality of performance and enables central storage for replenish and replacement.
The key challenge for all staff is to understand the importance of hydration and have a care plan that recognises and monitors progress for patients. Whatever the individual’s role, everyone has an opportunity to empower recovery for patients, even if it is a supporting measure for clinical colleagues. The training plans for Droplet at ward level have been difficult to control; emphasising the importance through Ward Sisters has helped to gain momentum and drive for nurses and health care assistants.
The success of the pilot encouraged a full review of the current service and how to initiate change. Phil Shelley presented a case to the Business Planning Management Group and the team was widely supported. Raising the project to the finance team achieved a suitable high profile which continued to give the required momentum. The Trust's volunteer service, League of Friends, also committed to the innovation and donated £5,000 towards the purchasing of stock for its shop on site as well as having a Droplet Stand at the Taunton Flower Show during the summer.
Results
Full roll out of Droplet throughout the hospital has achieved a number of key objectives:
• Focused approach on hydration
• Examination and review of care plans with a view to building something about Droplet into them
• Improved patient satisfaction and recovery
• Collaboration between Facilities and Clinical Teams
• Trust Board recognition and support
• Centralisation of stock and costs of ward crockery
• Monitoring through Nutrition Steering Group
At Musgrove Park Hospital there is a desire and a passion to ensure that patients receive the best care possible and the Facilities Team has a pivotal role to play.
The Project Team has spent an enormous amount of time encouraging staff at ward level to ensure that everybody maximises these efforts in supporting patient care, recognising that hydration and nutrition go hand in hand.
Chief Nurse Alison Wootton, Facilities Manager Phil Shelley, Ward Sisters Kerry Trunks and Emelie James have all been interviewed for TV, Radio and Hydration Seminars; this has brought recognition for the Trust, but most of all it has highlighted the necessity for all patients to have suitable hydration.
The Musgrove Team has also spent a great deal of time sharing their experiences with a number of hospitals across the UK. The Communications Team, Phil, Alison & Kerry have been responding to phone calls and emails to give their assessment of the Droplet product and the positive effects for patients.
Initiating a positive change drives decision-making and also a realisation at Executive level that teams are working collectively to improve patient care.
Overall this project has proved that clinical and non-clinical colleagues can form a formidable partnership in improving patient care.
