[Dysphagia] weekend coverage in acute care

[plarghi at msn.com (Patti Larghi)]

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