Hypodermoclysis in Long-Term Care: Utilization Patterns and Association With Staffing Levels

PURPOSE To determine the prevalence of hypodermoclysis use in long-term care (LTC) settings, describe associated clinical practices, and examine association between hypodermoclysis use and unit-level characteristics. METHODS Cross-sectional multicenter study based on data collected on a single day. Resident data from LTC units were collected by the supervising geriatricians of 27 LTC units affiliated with the Assistance Publique–Hôpitaux de Paris (AP-HP). Descriptive statistics summarized hypodermoclysis practices. A multivariable logistic regression was performed to assess the association between staffing levels and the likelihood of receiving hypodermoclysis. RESULTS Among 748 residents, 21% were receiving hypodermoclysis, with prevalence varying significatively across centers (14%–36%). Hypodermoclysis has been prescribed for a median duration of 95 days on the study day. It most commonly involved dextrose solution, prescribed at 500 mL per day. Factors independently associated with hypodermoclysis use included the resident-to-nurse ratio (OR = 0.73), the resident-to–nursing assistant ratio (OR = 1.75), and physician staffing (OR = 0.70). CONCLUSION Findings reveal heterogeneous use of hypodermoclysis in LTC, often at low volumes and over prolonged periods. Given the association between staffing levels and hypodermoclysis use, strengthened interprofessional engagement and collaboration may be needed to optimize hydration practices.