Use of hypodermoclysis in the treatment of elderly people in institutional care

Authors

  • Klavdija Kobal Straus Dom upokojencev Idrija, Arkova 4, 5280 Idrija

DOI:

https://doi.org/10.14528/snr.2014.48.1.10

Keywords:

dehydration, complications, hypodermoclysis, advantages of hypodermoclysis, nursing care

Abstract

Introduction: Hypodermoclysis is a way of administering fluids to the body by using a subcutaneous infusion. Research shows that this procedure is as effective as the more established intravenous infusion, posing no serious complications.

Method: For this study, a descriptive quantitative method was used. The data were gathered through a structured survey questionnaire specifically designed for the purpose of the study. It consisted of 14 questions. The questionnaire was completed and returned by 40 nursing care managers in the old people’s homes. The questionnaire was designed and distributed by means of the 1ka web tool on February 10, 2013 and the answers were collected by February 26,  2013. The data analysis was performed using the software package 1ka, MS Office (Word, Excel) and SPSS 18.0.

Results: With regard to geographical location of the old people’s homes inSlovenia, the familiarity with and the use of hypodermoclysis does not vary substantially (χ2 = 0.440, p = 0.507). Complications related to this procedure of administering fluids are rare when it is administered in conformity with accepted indications and guidelines. The risks of hypodermoclysis are not directly related to the rate of administration (χ2 = 0.000, p = 1.000). The research did not establish any correlation between the frequency of complications and the education level of the nursing staff (χ2 = 3.900, p = 0.420).

Discussion and conclusion: The research shows that hypodermoclysis is an established and widely used procedure among the professionals who took part in the research. As hypodermoclysis is a safe, easy and financially accessible way of administering fluids, suitable for use both in institutions as well as in home care, the time has come for resurrection and evaluation of this alternative infusion technique for widespread future use.   

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

References

AAFP., 2001. Hypodermoclysis: a way to replace lost fluids. Available at: http://www.rgpc.ca/best/BPC%20-%20Hydration/Hypodermoclysis-Family%20Handout-NP%20Hamilton.pdf [31. 3. 2013].

Allison, S.P. & Lobo, D.N., 2004. Fluid and electrolytes in the elderly. Current Opinion in Clinical Nutrition and Metabolic Care, 7(1), pp. 27–33. http://dx.doi.org/10.1097/00075197-200401000-00006, PMid:15090900

Arinzona, Z., Feldman, J., Fidelmana, Z., Gepstein, R. & Bernerb, Y.N., 2004. Hypodermoclysis (subcutaneous infusion) effective mode of treatment of dehydration in long-term care patients. Archives of Gerontology and Geriatrics, 38(2), pp. 167–173. http://dx.doi.org/10.1016/j.archger.2003.09.003, PMid:14698495

Barton, A., Fuller, R. & Dudley, N., 2004. Using subcutaneous fluids to rehydrate older people: current practices and future challenges. Quarterly journal of medicine, 97(11), pp. 765–768. PMid: 15496532.

Barua, P. & Bhowmick, B.K., 2005. Hypodermoclysis: a victim of historical prejudice. Age and Ageing, 34(3), pp. 215–217. http://dx.doi.org/10.1093/ageing/afi077, PMid:15863406

Bertoli, S.V. & Musetti, C., 2008. [Vascular access in the elderly: AVF vs CVC. A comment]. Giornale italiano di nefrologia, 25(6), pp. 625–627. PMid:19048555

Brown, M.K. & Worobec, F., 2000. Hypodermoclysis. Another way to replace fluids. Nursing, 30(5), pp. 58–59. PMid:10855196

Chapman, L., 2011. Procedure for the administration of subcutaneous fluids (Hypodermoclysis. Available at: http://www.tewv.nhs.uk/Global/Policies%20and%20Procedures/Clinical/CLIN-0053-v3%20Administration%20of%20Subcutaneous%20Fluids.pdf [31. 3. 2013]

Clinical Practice Committee., 2003. Hypodermoclysis (HDC) administration protocol for palliative care patients. Available at: http://www.masterpaliativos.com/ArchivosFTP/BackupXII/course_files/Documentacion_complementaria/hypodermoclysis.pdf [13. 4. 2013].

Clinical Practice Committee., 2006. Hospice palliative care, simptom guidelines, dehydration. Available at: http://www.fraserhealth.ca/media/06FHSymptomGuidelinesDehydration.pdf [29. 3. 2013].

Dalal, S. & Bruera, E., 2004. Dehydration in cancer patients: to treat or not to treat. Journal of Supportive Oncology, 2(6), pp. 467–487.

Faes, M.C., Spigt, M.G. & Olde Rikkert, M.G.M., 2007. Dehydration in geriatrics. Geriatrics and Aging, 10(9), pp. 590–596.

Fink, A., Jelen Jurič, J. & Kolar, J., 2011. Zdravstvena nega starostnika: učbenik za izbirni modul Zdravstvena nega v geriatrični dejavnosti v programu Zdravstvena nega. Ljubljana: Grafenauer, p. 216.

Fonzo-Christe, C., Vukasovic, C., Wasilewski-Rasca, A.F. & Bonnabry, P., 2005. Subcutaneous administration of drugs in the elderly: survey of practice and systematic literature review. Palliative medicine, 19(3), pp. 208–219. PMID: 15920935.

Hvalec, Š. & Kobal Straus, K., 2012. Storitev pomoč družini na domu z vidika zadovoljevanja potreb starostnika. In: Skela Savič, B., Hvalič Touzery, S. & Avberšek Lužnik, I. eds. Aktivno staranje kot multiprofesionalni izziv: zbornik prispevkov z recenzijo. 3. simpozij Katedre za temeljne vede, Begunje, 17. oktober 2012. Begunje: Visoka šola za zdravstveno nego Jesenice, pp. 104–113.

Jelen Jurič, J., 2009. Hipodermokliza - kljub številnim prednostim redko uporabljena metoda hidracije. Available at: http://www.google.si/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&ved=0CCgQFjAA&url=http%3A%2F%2Fwww.zbornica-zveza.si%2Fsites%2Fdefault%2Ffiles%2Fkongres_zbn_7%2Fpdf%2F242C.pdf&ei=ooETU9jHDOWT4ASVl4CACw&usg=AFQjCNEjWtNc3FR3GjGxd2ZgLmffsB3cJg&sig2=9WkOrcjJuF7oVxcBwrWVtw&bvm=bv.62286460,bs.1,d.Yms [25. 3. 2013].

Jéquier, E. & Constant, F., 2010. Water as an essential nutrient: the physiological basis of hydration. European Journal of Clinical Nutrition, 64(2), pp. 115–123. http://dx.doi.org/10.1038/ejcn.2009.111, PMid:19724292

Kain, V.J., Yates, P.M., Barrett, L., Bradley, T., Circosta, M., Hall, A. et al., 2006. Developing guidelines for syringe driver management. International Journal of Palliative Nursing, 12(2), pp. 6069. PMid:16603994

Kamal, A.H & Bruera, E., 2009. Hypodermoclysis - fast fact and concepts. Available at: http://www.mcw.edu/FileLibrary/User/jrehm/fastfactpdfs/Concept220.pdf? [1. 4. 2013].

Kerbler, B., 2011. Trajnostno bivanje starejših. Revija za geografijo, 6(2), pp. 4152. Available at: http://www.ff.um.si/zalozba-in-knjigarna/ponudba/zbirke-in-revije/revija-za-geografijo/clanki/stevilka-6-2-2011/062-06_kerbler1.pdf [7. 4. 2013].

Lawrence, S, Cromack, D. & Cooper, D., 2010. Policy for the administration of intravenous antibiotic therapy to adults within the community hospitals and community support teams within bachs. Available at: http://www.bradford.nhs.uk/wp-content/uploads/2010/07/IV-Antibiotic-Therapy-Administration-to-Adults-within-Community-Hospitals-and-Community-Support-Teams.pdf [27. 3. 2013].

Lopez, J.H. & Reyes-Ortiz, C.A., 2010. Subcutaneous hydration by hypodermoclysis. Reviews in Clinical Gerontology, 20(2), pp. 105–113.

Luk, J.K.H., Chan, F.H. & Chu, L.W., 2008. Is Hypodermoclysis suitable for frail chinese elderly? Asian Journal of Gerontology and Geriatrics, 3(1), pp. 49–50.

Macmillan, K., Bruera, E., Kuehn, N., Selmser, P. & Macmillan, A., 1994. A prospective comparison study between a butterfly needle and a teflon cannula for subcutaneous narcotic administration. Journal of Pain and Symptom Management, 9(2), pp. 82–84. PMid:8021539

Mayhew, M.S., 2002. What should i know about using hypodermoclysis in geriatric patients? Available at: http://www.medscape.com/viewarticle/413369 [1. 4. 2013].

Mercadante, S., Ferrera, P., Girelli, D. & Casuccio, A., 2005. Patients' and relatives' perceptions about intravenous and subcutaneous hydration. Journal of Pain and Symptom Management, 30(4), pp. 354–358. PMid:16256899

Nacionalni program socialnega varstva za obdobje 2013-2020., 2012. Osnutek, gradivo za javno razpravo. Available at: http://www.soczbor-sl.si/4Aktualno/Dokumenti/NPSV_2013-2020_121012.pdf [28. 3. 2013].

National Risk Manager., 2012. Protocol on subcutaneous (SC) fluids (hypodermoclysis) administration. Available at: http://www.cheshire.ie/docs/staff/policies/clinical/MedicationManagement/SubcutaneousFluidAdministrationCLSP16.pdf [9. 2. 2013].

O‘Keeffe, S.T. & Lavan, J.N., 1996. Subcutaneous fluids in elderly hospital patients with cognitive impairment. Gerontology, 42(1), pp. 36–39. PMid:8641599

Pratt, R.J., Pellowe, C.M., Wilson, J.A., Loveday, H.P., Harper, P., Jones, S.R.L.J. et al., 2006. National evidence-based guidelines for preventing healthcare-associated infections in NHS hospitals in England. London: Richard Wells Research Centre, Thames Valley University. Available at: http://microtrainees.bham.ac.uk/lib/exe/fetch.php?media=epic2_20-_2021aug06_20final_20draft_20for_20consultation.pdf [9. 4. 20139].

Ramovš, J., 2003. Kakovostna starost: socialna gerontologija in gerontagogika. Ljubljana: Inštitut Antona Trstenjaka.

Reginelli, A., Iacobellis, F., Del Vecchio, L., Monaco, L., Berritto, D., Di Grezia, G. et al., 2013. VFMSS findings in elderly dysphagic patients: our experience. BMC Surgery, 13 Suppl 2, p. S54.

http://dx.doi.org/10.1186/1471-2482-13-S2-S54

PMid:24267870; PMCid:PMC3851185

Remington, R. & Hultman, T., 2005. Hypodermoclysis to treat dehydration: a review of the evidence. Journal of the American Geriatrics Society, 55(12), pp. 2051–2055. http://dx.doi.org/10.1111/j.1532-5415.2007.01437.x, PMid:17971137

Ross, J.R., Saunders, Y., Cochrane, M. & Zeppetella, G., 2002. A prospective, within-patient comparison between metal butterfly needles and teflon cannulae in subcutaneous infusion of drugs to terminally ill hospice patients. Palliative Medicine, 16(1), pp. 13–16. PMid:11963447.

Sasson, M. & Shvartzman, P., 2001. Hypodermoclysis: an alternative infusion technique. American Family Physician, 64(9), pp. 1575–1578. PMid: 11730312.

Scales, K. & Pilsworth, J., 2008. The importance of fluid balance in clinical practice. Nursing Standard, 22(47), pp. 50–57. PMid: 18777823.

Scales, K., 2011. Use of hypodermoclysis to manage dehydration. Nursing older people, 23(5), pp. 16–22. PMid:21736101

Skupnost socialnih zavodov Slovenije., 2013. Seznam članov s povezavami. Available at: http://www.ssz-slo.si/seznam-domov-clanov-s-povezavami [13. 2. 2013].

Skupnost socialnih zavodov Slovenije. 2013a. Splošno o domovih in posebnih zavodih. Available at: http://www.ssz-slo.si/splosno-o-domovih-in-posebnih-zavodih [26. 3. 2013].

Slesak, G., Schnürle, J.W., Kinzel, E., Jakob, J. & Dietz, P.K., 2003. Comparison of subcutaneous and intravenous rehydration in geriatric patients: a randomized trial. Journal of the American Geriatrics Society, 51(2), pp. 155–160. PMid:12558710

Turner, T. & Cassano, A.M., 2004. Subcutaneous dextrose for rehydration of elderly patients: an evidence-based review. MC Geriatrics, 4:2 Available at: http://www.biomedcentral.com/content/pdf/1471-2318-4-2.pdf [2. 4. 2013].

Wedro, B. (2012). Dehydration. Available at: http://www.medicinenet.com/dehydration/page2.htm [3. 2. 2013].

Wiles, J.L., Leibing, A., Guberman, N., Reeve, J. & Allen, R.E.S., 2012. The meaning of "aging in place" to older people. Gerontologist, 52(3), pp. 357–366. http://dx.doi.org/10.1093/geront/gnr098, PMid:21983126

Witlox, J., Eurelings, L.S., de Jonghe, J.F, Kalisvaart, K.J., Eikelenboom, P. & van Gool, W.A., 2010. Delirium in elderly patients and the risk of postdischarge mortality, institutionalization, and dementia: a meta-analysis. Journal of the American Medical Association, 304(4), pp. 443–451. http://dx.doi.org/10.1001/jama.2010.1013, PMid:20664045

Young, J., 2007. Administration of subcutaneous fluids. Available at: http://www.bolton.nhs.uk/Library/policies/NursDA011.pdf [13. 4. 2013].

Published

2014-04-03

How to Cite

Kobal Straus, K. (2014). Use of hypodermoclysis in the treatment of elderly people in institutional care. Slovenian Nursing Review, 48(1). https://doi.org/10.14528/snr.2014.48.1.10

Issue

Section

Professional article