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Availability and perceived usefulness of guidelines and protocols for subcutaneous hydration in palliative care settings

Author

Listed:
  • María José Cabañero‐Martínez
  • Juan Diego Ramos‐Pichardo
  • María Luisa Velasco‐Álvarez
  • Sofía García‐Sanjuán
  • Manuel Lillo‐Crespo
  • Julio Cabrero‐García

Abstract

Aims and objectives To evaluate the availability of, adherence to, and perceived usefulness of guidelines and protocols for managing hydration and subcutaneous hydration in palliative care settings. Background Hydration at the end of life and the use of a subcutaneous route to hydrate generate some controversy among health professionals for different reasons. Having guidelines and protocols to assist in decision‐making and to follow a standard procedure may be relevant in clinical practice. Design Cross‐sectional telephone survey, with closed‐ended and open‐ended questions designed specifically for this study. Methods Data were obtained from 327 professionals, each from a different palliative care service. Mean, standard deviation, minimum and maximum were calculated for continuous variables; frequency distributions were obtained for categorical variables. A qualitative content analysis was performed on the open‐ended questions. The article adheres to the STROBE guidelines for reporting observational studies. Results Only 24.8% of the participants had guidelines available to assist in making decisions regarding hydration, and 55.6% claimed to follow them ‘always or almost always’. Of the participants, 38.8% had subcutaneous hydration protocols available, while 78.7% stated that they ‘always or almost always’ followed these protocols. The remaining participants considered the protocols as useful tools despite not having them available. Conclusions Only 25% of the participants' services had guidelines for hydration, and less than 40% had protocols for subcutaneous hydration. However, adherence was high, especially in cases where protocols existed. Among the participants who did not have guidelines and protocols, attitudes were mostly favourable, but mainly as a reference and support for an individualised clinical practice. Relevance to clinical practice Guidelines and protocols on hydration in palliative care may be more useful as a solid reference and support for individualised practice than as instruments for standardising care. From this perspective, their development and availability in palliative care services are recommended.

Suggested Citation

  • María José Cabañero‐Martínez & Juan Diego Ramos‐Pichardo & María Luisa Velasco‐Álvarez & Sofía García‐Sanjuán & Manuel Lillo‐Crespo & Julio Cabrero‐García, 2019. "Availability and perceived usefulness of guidelines and protocols for subcutaneous hydration in palliative care settings," Journal of Clinical Nursing, John Wiley & Sons, vol. 28(21-22), pages 4012-4020, November.
    • Handle: RePEc:wly:jocnur:v:28:y:2019:i:21-22:p:4012-4020
    DOI: 10.1111/jocn.15036
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    References listed on IDEAS

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    1. David A Cook & Laurie J Pencille & Denise M Dupras & Jane A Linderbaum & V Shane Pankratz & John M Wilkinson, 2018. "Practice variation and practice guidelines: Attitudes of generalist and specialist physicians, nurse practitioners, and physician assistants," PLOS ONE, Public Library of Science, vol. 13(1), pages 1-12, January.
    2. Liz Forbat & Natalie Kunicki & Michael Chapman & Clare Lovell, 2017. "How and why are subcutaneous fluids administered in an advanced illness population: a systematic review," Journal of Clinical Nursing, John Wiley & Sons, vol. 26(9-10), pages 1204-1216, May.
    3. Isabel Higgins & Pamela van der Riet & Ludmilla Sneesby & Phillip Good, 2014. "Nutrition and hydration in dying patients: the perceptions of acute care nurses," Journal of Clinical Nursing, John Wiley & Sons, vol. 23(17-18), pages 2609-2617, September.
    4. Corallo, Ashley N. & Croxford, Ruth & Goodman, David C. & Bryan, Elisabeth L. & Srivastava, Divya & Stukel, Therese A., 2014. "A systematic review of medical practice variation in OECD countries," Health Policy, Elsevier, vol. 114(1), pages 5-14.
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