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1、EffectsofaFreeWaterProtocolforPatientswithDysphagiaPresentedattheASHAConvention,ChicagoNovember21,2008ChristinaR.Bronson-Lowe,M.S.CCC-SLPKateLeising,Ph.D.CCC-SLPDanielBronson-Lowe,Ph.D.ShellyLanham,M.S.CCC-SLPStefanieM.Hayes,M.S.CCC-SLPAngeleneM.Ronquillo,M.S
2、.CCC-SLPPaulA.Blake,M.D.Contact:crlowe@gmail.comSettingJohnJ.RhodesRehabilitationInstituteatBannerMesaMedicalCenter,MesaAZInpatient/acuterehab2PatientsThosewhosedietconsistencywasrestrictedfromthinliquidsduetodysphagiaAnylevelofPOdietnotincludingthinliquids,u
3、ptoandincludingNPOReducedthirstsatiationandfluidintakeforpatientsonthickenedliquids(Garonetal.,1997;Finestoneetal.,2001)Maynotmeetfluidrequirements(Finestoneetal.,2001)Reducedqualityoflifeandcompliancewithrestrictions(Purdy,2006)3FreeWaterProtocol(FWP)KathyPa
4、nther,MSCCC-SLPFrazierRehabInstitute,1984ThinwaterbetweenmealsOralhygienePatient-specificprecautionsMinimizeriskofsequelaefromepisodesofwateraspirationwhichitisassumedwilloccurGaronetal(1997)Knownthinliquidaspirators10with,10withoutFWPNoaspirationpneumoniaord
5、ehydrationineithergroupPanther(2005)FWPreview(notstudy)Mentionschartreview:234inpatientsonthickliquids;2developedaspirationpneumonia;bothsuspectedofsolidfoodaspiration4GoalsTotestthehypothesesthatwecan…improvepatients’fluidintake…reducetheirriskofdehydration…
6、accomplishtheabovewithoutincreasingtheirrateofpneumonia5ImplementationStafftraining(SLPs,MDs,RNs,CNAs,PTs,OTsetc)Patientandfamilytrainingintheprotocol,patient-specificaspirationprecautions,andoralhygienePostedprotocolandpatient-specificaspirationprecautionsin
7、room&diningroomOrdersinchartwithvisualremindersonnursingboardandpatientwheelchairs6DesignIntended:retrospectiveinterventiontrialwithhistoricalcontrols(viachartreview)Interventiongroup:allpatientsreceivingFWP,Sept.2006toJuly2007(N=30)Hist.controls:allpatientsw
8、howouldhavebeeneligibleforFWP,Sept.2005toJuly2006(N=46)UnplannedadditionPatientsduringthepost-FWP-implementationtimeperiodwhowereeligibleforFWPbutdidnotreceiveit(N=25)Becameconcurrentcont
