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BRANCH news south australia

Research projects underway in South Australia

Lara Ferris – Women’s and Children’s Hospital, Adelaide

Women’s and Children’s Hospital Speech Pathologist Lara Ferris has recently commenced her doctoral studies through Flinders University. Lara is working 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, with a research team headed by Associate

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

PhD candidate Lara Ferris.

the clinical utility of these measures in relation to the adverse health outcomes which specifically link to paediatric dysphagia.

Paediatric validation studies with concurrent videofluoroscopy are currently taking place in Leuven. Lara’s doctoral studies aim to validate

combined to derive a Swallow Risk Index.

Jo Murray – Flinders University, Adelaide

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

PhD candidate Jo Murray. 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 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

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 joanne.murray@flinders.edu.au .

Speak Out August 2014

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