An exploration of dietetic student perceptions regarding hydration at the ommencement of enteral feeding
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Background: Dehydration has been shown to have significant negative consequences for the enterally-fed. Despite this, no explicit screening tools for dehydration are identified in the literature. Additionally, guidelines fail to explicitly identify methods of meeting fluid requirements at commencement of enteral feeding, possibly increasing the risk of dehydration. This study aimed to investigate the perceptions/experiences of student dietitians regarding hydration practices in enteral feeding, screening tools for dehydration and the barriers to guideline implementation. Methods: A cross-sectional survey was used to explore the experiences of 24 dietetics students on enteral feeding practices. All students had completed 28 weeks of practical training in health boards across Wales. Results: Of the 24 participants, only 8% (n=2) identified that hydration needs are always met at commencement of enteral feeding. Additionally, 50% of participants agreed that dehydration was common at commencement of enteral feeding. No participants identified explicit tools for screening of dehydration, although all participants could identify methods of diagnosing dehydration. Doctors and nurses were most commonly identified as involved in meeting requirements (92%, n=22 & 92%, n=22 respectively), although no statistical significance was found between identified healthcare professionals and barriers to meeting fluid requirements. Conclusion: The results suggest that there is scope for improvement in enteral feeding practices regarding hydration. The results support other research in that no explicit methods of screening for dehydration currently exist. Development of a robust tool for dehydration screening could, therefore, help improve hydration standards in acute-care settings. Additionally, dietitians are well-placed to work with other members of the multidisciplinary team (MDT) to raise awareness of the importance of adequate hydration in the enterally-fed. Thus, further exploration into the barriers to meeting fluid requirements and MDT members involved could help highlight where health improvement efforts could be focussed.
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