Imagination & Innovation in Evidence Based Nursing Care

Imagination &
Innovation in
Evidence Based
Nursing care – Level
6.
PROJECT PROPOSAL & MANAGEMENT PLAN.
Name/Student Number:
Field of Nursing:

Introduction.
Dehydration is a severe health condition, which affects the water balance
mechanism of the human body and consequently affected individuals suffer from
severe healthcare complications. As per Frangeskou et al. (2015), the elderly
population is most affected by this lifestyle disorder and puts a considerable
clinical impact on their healthcare. The primary aim of this project proposal plan
is to highlight the prevalence of the dehydration condition among the elderly
population (65 and over) in the United Kingdom and analyse the age, gender,
lifestyle (living alone) and risk factors associated to it. Besides this, the paper
would highlight the primary contributing factors for the dehydration among the
elderly population with age 65 and above in the United Kingdom, who are living
alone in their community. The innovation that would be proposed to implement
for the specific community mentioned is talking alarm clock so that they could be
reminded with their hydration strategy and providing them with leaflets to
implement patient education in the healthcare process.
Project Proposal Briefing Paper (500 words)
Field of Nursing
(Adult, Child,
Learning Disability
or Mental Health).
providing patient education and reminder intervention among elderly population so that effective awareness could be achieved
Proposed
Project/Innovation.
Contextualize the
choice & clearly
define the focus of
the project proposal
that has been
generated and
informed from your
area of practice?
(For example, what
is the proposed
project and where
are you proposing
the project could be
implemented)?
Include supporting
literature/evidence
in this section.
Dehydration is a health condition in which the amount of fluid or water reduced
and decreases the functioning of the body. This condition may vary from mild,
moderate to severe due to which affected people may suffer from various health
conditions (Shimizu et al., 2012). The elderly population is affected by
inadequate hydration condition majorly due to their physiological inabilities and
aging process (Miller, 2017). It has been observed through the research of
Konings et al. (2015) that aging decreases the sensation or urge to consume
water due to which the chance of older population to acquire several diseases
and disorders such as diabetes, thrombo-embolic complications, low blood
pressure, medicinal intoxication, urinary tract infections, kidney failure,
Alzheimer’s disease as well as delirium (mental/cognitive dysfunction) increases
(Fortes et al., 2015). It has been observed through the data provided by the
World Health Organisation (2014) that more than 75% of the elderly people
admitted to the healthcare facilities reported the signs and symptoms of
dehydration and associated complications and the fatality may rise up to 50% in
severe conditions. Therefore, a proper hydration strategy and the promotional
program should be proposed so that hydration could be reinforced in elderly
people (Shimizu et al., 2012). Including talking alarm clock and providing health
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(Suggested 200
words).
literacy to the elderly population are effective strategies to increase the water
uptake among the chosen population because as per Miller (2017), it could
increase their urge of drinking water to maintain a hydrated state as they would
be aware of the benefit it would exert on their health condition.
Project
Aim/Objectives.
The project aim
should be clear and
precise and inform
the marker about
the main intention of
the project.
The objectives
should be more
specific and provide
the marker with an
insight into what
your project sets out
to achieve. Try to
ensure the
objectives are,
Specific,
Manageable,
Achievable,
Realistic and Time
scaled (SMART
Objectives).
(Suggested 50
words).
While targeting the single elderly individuals living in a district nursing caseload it was
observed that majority of the elderly population over the age of 65 were housebound
and were completely depending on the nursing professionals for their health and
wellbeing. Hence, while proposing a hydration strategy for this community the aim of
the proposal would be providing awareness to the community in subject living alone in
their houses about the proposed strategy. This aim of adequate water consumption
level in the chosen community, three objectives would be achieved. These are:
1. Provide them with the education about adverse effects of inadequate
water level in human body and the severe complications it could lead to in
their health condition and implementation of this process would be
conducted for the first month of the proposed strategy implementation. This
would help them to increase their understanding of proper hydration routine
hence would benefit their health. This would be conducted for 3 months so
that with every educational session, their ideations could be improved.
However, it could also increase their stress by informing their health-related
risks. Further, it would be evaluated through an open-ended questionnaire
so that their knowledge regarding the process could be identified.
2. Providing them with the interventions such as pamphlets of patient
education and talking alarm clock as the reminder to increase their
consumption level and making them aware to use the process and conduct
this process for 3 months. This would also benefit them by informing the
benefits it could bring for their healthcare. However, in this aspect, their
forgetfulness could be the limitation as provided information might not be
understood by the patients. The intervention would last for 1 month and
evaluation of their knowledge would be done by questionnaire and their
previous knowledge of the process would be compared with the recent one.
3. The third objective would be assessing the health literacy of the chosen
population and then conduct a detailed analysis of the effectiveness of the
talking alarm clock in increasing the water consumption level. An
assessment would benefit the assessors to understand the lack and
loopholes in the process and they would be able to implement further
strategies for their benefit. However, with improper assessment, the
loopholes of the process would not be assessed properly and persistent
lack of knowledge would affect their understanding. This would be done by
conducting interviews with them and comparing their previous d current
knowledge after providing health literacy.
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Rationale.
Create a sound and
coherent argument
for an appropriately
selected work-
based project.
The rationale
should provide an
explanation as to
why you have
chosen to focus
your project on a
particular area of
practice within your
own field of
nursing. For
example, what has
caused you to
identify this area of
practice? The
rationale provides
the opportunity to
put your argument
forward to support
the proposed
project.
Include supporting
literature/evidence
in this section.
(Suggested 200
words).
Dehydration is a health condition which is generally not considered or cared by the
sufferer or people around them as the majority of the people suffering from
dehydration are unable to understand the consequences of it (Miller, 2017). Further,
as previously mentioned by the World Health Organisation (2014) majority of the
elderly patients who admit to healthcare facilities, 30% of the people are older than 65
years. Hence, this population has been chosen as the target population for this project
proposal management plan. Frangeskou et al. (2015) mentioned that people generally
ignore their symptoms of dehydration because of prevailing unawareness due to
which, they become susceptible to several diseases and disorders affecting their
physical, mental and cognitive strength (Frangeskou et al., 2015). Therefore, it has
become an important aspect and awareness regarding dehydration should be spread
among the most susceptible age group so that they could be prevented from such an
adverse condition.
Potential /
Intended
Outcome.
How will your
project
proposal/innovation
meet the NHS
Outcomes
Framework?
Include supporting
literature/evidence
in this section.
(Suggested 50
words).
In this course, providing them with awareness program, promotional strategies and
interventions could increase their fluid uptake (Kinoshita et al., 2013). This project
helps to achieve the NHS outcome framework as through providing people with
proper environment and education helps them to protect themselves and avoid the
adverse consequences (NHS, 2018).
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Reference List.
(Key literature /
evidence cited
within the Project
Proposal Briefing
paper only).
Please note: The
accompanying
reference list is not
included in the word
count for the Project
Proposal Briefing
paper.
Fortes, M. B., Owen, J. A., Raymond-Barker, P., Bishop, C., Elghenzai, S., Oliver, S.
J., & Walsh, N. P. (2015). Is this elderly patient dehydrated? Diagnostic accuracy
of hydration assessment using physical signs, urine, and saliva markers. Journal
of the American Medical Directors Association, 16(3), 221-228.
Frangeskou, M., Lopez-Valcarcel, B., & Serra-Majem, L. (2015). Dehydration in the
elderly: A review focused on economic burden. The journal of nutrition, health &
aging, 19(6), 619-627.
Kinoshita, K., Hattori, K., Ota, Y., Kanai, T., Shimizu, M., Kobayashi, H., &Tokuda, Y.
(2013). The measurement of axillary moisture for the assessment of dehydration
among older patients: a pilot study. Experimental gerontology, 48(2), 255-258.
NHS. (2018). NHS Outcomes Framework (NHS OF) - NHS Digital. Retrieved from
https://digital.nhs.uk/data-and-information/publications/ci-hub/nhs-outcomes-
framework
Shimizu, M., Kinoshita, K., Hattori, K., Ota, Y., Kanai, T., Kobayashi, H., &Tokuda, Y.
(2012). Physical signs of dehydration in the elderly. Internal Medicine, 51(10),
1207-1210.
World Health Organisation. (2014). World Health Organisation. Retrieved from
https://apps.who.int/iris/bitstream/handle/10665/104772/9789241506823_Module
-4_eng.pdf;jsessionid=E9DA09C5C480DAC10C99282895F59BC6?sequence=6
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Literature Review
Dehydration-related health complications not only affect the physical abilities pf
elderly population but also disrupts the water maintenance structure of the body
and would affect the cognitive ability of the person (Konings et al., 2015). As the
primary aim of this proposal is to increase the level of awareness among the
elderly population living in a specific district nursing caseload, the literature
review would assess the prevalence of dehydration among the UK elderly
population and understanding the risk factors such as age and gender, ability to
communicate socially could be assessed (Frangeskou et al., 2015). Further,
through the identification of dehydration related harms, the contributing factors
for their dehydration conditions would be assessed.
Prevalence of dehydration: The first research article which should be discussed
under this theme would be from the researchers Hooper et al. (2015), the primary
aim of which is to assess the prevalence of dehydration among the elderly
population of United Kingdom. For this purpose, the researchers selected elderly
people over the age of 65 who were living in long term care centers. Researchers
collected the participants living in the long term, care centers with no history of
renal or cardiac conditions. For this research process, researchers conducted a
cross-sectional study so that through the process, chosen participant’s serum
osmolality, general health, a risk of dehydration and the symptoms of dehydration
could be assessed. Further, in the selected 118 participants 66% were women
and the mean age of the participants was 86 years. Data of the research study
were collected from the registered or community nursing professionals involved
in the study and then assessed their serum osmolality (the normal range is 275
to 295mOsm/kg) as well as conducted MSME process to assess their cognitive
behaviour. After completion of the research, the findings indicated the fact that
the majority of the participants suffering from dehydration were seen this
increased level of serum osmolality and hence, they were detected with diabetes
condition. Further, it was also seen through the research that majority of the
elderly adults who were diagnosed with dehydration, were observed with
cognitive impairment and hence, researchers indicated to the findings that due to
lack of cognitive abilities, elderly adults were unable to feel the urge of thirst
which leads them to develop severe dehydration condition. However, the primary
limitation of this research process was the selection of the participants was done
on the basis of the risk of dehydration but on the basis of the less complex
healthcare complication among the elderly population so that their resulting
dehydration condition could be assessed through proper observation.
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