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[Dysphagia] FYI: Neuro exam infants andchildrenvideopresentationsonline
My point was not about providing seven day a week coverage. My point was about having either NPO status -or- a puree diet with honey-thick liquids as the choices of what to give a patient who has not yet been seen by an SLP. There are many other, and better, options for the patients.
-----Original Message-----
From: Sally.Gorski@co.hennepin.mn.us [mailto:Sally.Gorski@co.hennepin.mn.us]
Sent: Thursday, August 10, 2006 11:08 AM
To: Thompson, Elana
Cc: dysphagia@b9.com; dysphagia-bounces@b9.com
Subject: RE: [Dysphagia] FYI: Neuro exam infants andchildrenvideopresentationsonline
The decision was made for us regarding Sunday coverage (we have been providing Saturday coverage for new consults for years). JCAHO's mandate regarding "one level of care" was the driving force behind the decision to add Sunday coverage. That is, a patient entering the hospital on a Saturday afternoon (for example) should expect and receive the same level of care that other patients receive Mon-Fri. Our Neurology team also consults speech path on almost every patient on their service so it just made sense to add Sunday coverage even though we (the speech path staff) have been resisting this idea for years. For many years our PT colleagues have provided 7 day/week including Holiday coverage and our OT colleagues added Sunday coverage a couple of years ago. We're a Level One trauma center, teaching hospital, acute rehab, etc. The change to Sat/Sun coverage not only impacted our dept, but also departments such as EEG, Cardiac Rehab, EMG, etc. These are all services that the patient would typically have to wait until Monday morning if they were admitted anywhere between late Fri afternoon and Mon morning. It's a sign of the times I think especially in large metropolitan facilities. However, at this point, we are not coming in on the six major holidays - so we aren't here 365 days ------- yet!
Staffing Sundays is a challenge and I won't get into it in this post.
"Thompson, Elana" <EThompson@mountnittany.org>
Sent by: dysphagia-bounces@b9.com
08/10/2006 09:47 AM
To
"Irene Campbell-Taylor" <eripley@yahoo.com>, "Erin Powazek" <epowazek@hotmail.com>, <jsaunt@hotmail.com>, <dysphagia@b9.com>
cc
Subject
RE: [Dysphagia] FYI: Neuro exam infants andchildrenvideopresentations online
I was hoping to get that response from Irene since I have read it before.
I guess that is why I was wondering why the doctors at that subscriber's workplace would automatically make a patient NPO or put him/her on the puree/honey diet just because an SLP is not there for the weekend. It doesn't make sense that those would be the only two solutions to having no weekend coverage. It seems to me to be a disservice to the patient.
We have no weekend coverage, per say, at the acute care facility in which I work and the doctors will either keep a person NPO if that is called for or will start a diet like clear liquids or even soft regular and then will have the SLP eval on Monday. We do not have an increased number of pneumonias or deaths by not using thickeners and puree as some sort of false safety net.
________________________________
From: Irene Campbell-Taylor [mailto:eripley@yahoo.com]
Sent: Thu 8/10/2006 8:34 AM
To: Thompson, Elana; Erin Powazek; jsaunt@hotmail.com; dysphagia@b9.com
Subject: RE: [Dysphagia] FYI: Neuro exam infants andchildrenvideopresentations online
"Thompson, Elana" <EThompson@mountnittany.org> wrote:
What makes a puree diet with honey-thickened liquids safe?
*** Who says that it is "safe"? What evidence is there?
Is there evidenced-based data that that is a clinically safer diet?
*** There are no evidence-based data in oropharyngeal dysphagia.
Dr I Campbell-Taylor
Clinical Neuroscientist
Exclusive Distributor:
www.interactivetherapy.com
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