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p eech
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athology
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ustralia
MULTICULTURALISM AND DYSPHAGIA
n
no aspiration related adverse events;
n
improved QOL/satisfaction scale measures ;
n
improved overall fluid intake;
n
improved acceptance of thickened fluids when they are
not the sole option.
After considering the results more carefully, we plan to
write up the results and submit them for publication later in
2009.
I
n early 2008, clinicians at The Royal Melbourne Hospital
(RMH) commenced a quality project to formalise a free
water policy (FWP) and collect outcome data. Specifically, we
aimed to look at pre and post FWP quality of life (QOL) and
medical status measures (including hydration and aspiration
related adverse events).
The FWP was introduced after obtaining formal clearance
from the Ethics Committee at the hospital. Prior to the project,
most clinicians at RMH were using the FWP on an ad hoc
basis with anecdotally encouraging outcomes. The Free Water
Policy is subject to strict criteria at RMH, based on the
literature and developed in consultation with respiratory and
general medical specialists. They include:
n
all solids/medicines are taken with thickened fluids;
n
no active pneumonia/chest infection;
n
adequate oral hygiene;
n
sips of water without excessive/uncomfortable coughing/
choking;
n
supervision for impulsive patients or those who cough
excessively;
n
participant with compromising lung condition to be
discussed with registrar or consultant; and
n
deemed clinically appropriate by the speech pathologist.
The quality project collected data on 50 patients from a
range of medical and surgical units (including patients
considered to be compromised from a respiratory point of
view, such as chronic obstructive pulmonary disease, lung
capacity and asthma). While not fully analysed to date,
preliminary data have shown:
Free water policy quality project
Kate Mills
Kate Mills
has been a speech pathologist at the Royal
Melbourne Hospital for the last 6 years, with some
experience in rehab but the majority in acute. When she
started this project Kate was working primarily in
General Medicine, Trauma and Respiratory Care, but has
since moved into Head & Neck. She has great interest in
dysphagia and particularly maximising the quality of life
for patients on modified diets.
Correspondence to:
Kate Mills
Speech Pathologist
Free Water Policy Project Leader
C/o Post Office
The Royal Melbourne Hospital
Grattan Street
Parkville, VIC 3050
email:
kate.mills@mh.org.au