[Dysphagia] weekend coverage in acute care

[connorswa at ph.upmc.edu (Connors, William A.)]

Interesting approach - just stick an NG tube in 'em.  I guess that's OK as long as it's not my mother who is doing the waiting or is receiving the uncomfortable NG tube unnecessarily.   This seems quite a bit like inequitable discrimination and providing different levels of care to patients of similar levels and diagnoses which violates, in the U.S., acute care JCAHO regulations.   What say you all?

-----Original Message-----
From: dysphagia-bounces@b9.com [mailto:dysphagia-bounces@b9.com]On Behalf Of Morgan Jennie (RXP) Speech & Language Therapy
Sent: Tuesday, January 25, 2005 10:07 AM
To: Patti Larghi; dysphagia@b9.com
Subject: RE: [Dysphagia] weekend coverage in acute care

It sounds like your patients get reasonable treatment only waiting up to 24 hours. Working in the NHS in Britian most hospitals do not have SLT cover for weekends. If a patient is referred late on a Friday afternoon then they have to wait until Monday morning before they are seen, which means that they are NBM for the whole time.
Obviously this is far from ideal but we are not willing to lose our Monday-Friday working practice. If a doctor is concerned about nutrition and hydration then they often pass an NG tube until the patient can be assessed by our department.

Jennie Morgan
Speech and Language Therapist
Durham

________________________________

From: dysphagia-bounces@b9.com on behalf of Patti Larghi
Sent: Tue 25/01/2005 14:53
To: dysphagia@b9.com
Subject: [Dysphagia] weekend coverage in acute care



I am hoping to get some feed back from those of you that work in an acute
care setting. More specifically smaller hospitals that don't have regular
weekend coverage.  Firstly, we are trying to establish a protocal for
nursing to use as a screening tool to establish a need for an order for a
swallow eval.
The second part of the problem is covering the swallow evals once they are
written. Currently we use an on-call program. The SLP has 24 hours to
respond. The problem is of course those patients that enter the hospital on
Friday p.m. and the physician writes on order for patient to be NPO until
evaluated by SLP. If our on-call therapist can not make it until Sat. p.m.
we feel this is an excessive length of time for the patient to wait  but at
this point we are in a dilema at to how to solve this issue.
Our nursing director suggested that the patinet receive a dysphagia diet
(Pureed honey thick liquids) until the eval and that the nurse be provided
with a screening tool to assure diet tolerance.
Anyway I would appreciate some feed back from those of you working in
simliar settings as to what your hospitals are currently doing to keep
patient safe and to provide nutrition in a timely manner.

Thanks, Patti Larghi


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