Speak Out
August 2014
31
BRANCH news
south australia
PhD candidate Lara Ferris.
PhD candidate
Jo Murray.
Women’s and
Children’s
Hospital Speech Pathologist
Lara Ferris has recently
commenced her doctoral
studies through Flinders
University. Lara is working
with a research team
headed by Associate
Professor Taher Omari in the
hospital’s Gastroenterology
Department. The use of High
Resolution Manometry and
Impedance (HRMI) is being
investigated for its use in
dysphagia assessment in the
paediatric setting.
With thanks to the May
Fotheringham Fellowship
Award, beginning in October
last year Lara spent eight
weeks at the Leuven
University Hospital in Belgium,
observing clinical processes
and working on a research
project under Professor
Nathalie Rommel, who
heads the swallow research
collaboration in Belgium.
HRMI is a nasogastric
catheter-based procedure
which allows for integrated
pressure and flow analysis
during swallowing. Measures
provide functional description
of the swallow process
relating to lingual propulsion,
strength of the pharyngeal
stripping wave, pharyngeal
intra-bolus pressures and
upper oesophageal
sphincter opening. Together
these measures can be
combined to derive a
Swallow Risk Index.
Paediatric validation
studies with concurrent
videofluoroscopy are
currently taking place in
Leuven. Lara’s doctoral
studies aim to validate
the clinical utility of these
measures in relation to the
adverse health outcomes
which specifically link to
paediatric dysphagia.
Research projects underway in South Australia
Thickened fluid prescribing and
monitoring practices by Australian
health professionals
You may
remember
being asked to
participate in a survey
in April 2013. If you
took up the offer
to fill in the survey,
thank you! You were
one of 656 health
professionals who
did (including 387 speech pathologists,
158 nurses and 131 dietitians).
The survey aimed to find out how
clinical teams supply and monitor
thickened fluid consumption for
patients with dysphagia. Through
this survey and the larger research
program being conducted by Jo Murray
(PhD candidate, Flinders University)
entitled ‘Fluid intake, hydration and
health status of stroke inpatients with
and without dysphagia’, we hope to
identify the reasons for poor fluid intake
when patients are prescribed
thickened fluids and ultimately find
ways to improve the hydration and
health status of dysphagic patients.
The results of the survey have been
published in the
Journal of Evaluation
in Clinical Practice
:
Murray, J., Miller, M., Doeltgen,
S. & Scholten, I. (2014). A survey
of thickened fluid prescribing and
monitoring practices of Australian health
professionals.
Journal of Evaluation in
Clinical Practice
, doi:10.1111/jep.12154
(Accepted for publication: 3 April 2014)
Here are a few of the findings you
might find relevant:
•
Pre-packaged thickened fluids
are the most prevalent way that
thickened fluids are supplied (82%
of respondents)
•
The most common amount of
thickened fluids offered per day
was 1200ml to 1400ml (24% of
respondents)
•
In the opinion of 51% of
respondents, clients do not
drink adequate amounts when
on thickened fluids
•
The main reasons cited were
palatability of the thickened
products themselves; patients’
dependence on others for
drinking; inadequate assistance
from staff and inconsistent
systems for monitoring fluid intake
and signs of dehydration
•
Few facilities (17%) monitored
thickened fluid consumption
routinely (only if a clinical need was
recognised)
•
The most common way to
address inadequate intake was
for nurses to “push fluids” (87%)
•
Free water protocols were
used only 14% of the time.
Please direct any queries or
correspondence regarding this study to
Lara Ferris – Women’s and Children’s Hospital, Adelaide
Jo Murray – Flinders University, Adelaide
