DiagnosTEX June 2017 Newsletter
Summer is back!
Clinical Café Newsletter
By: Ronda Polansky M.S. CCC-SLP
Happy Father’s Day to all the DADs!
Do not forget to fly your American flag on the 14th in honor of our country, our troops and our freedom!
Flag Day falls within National Flag Week, a time when Americans reflect on the foundations of the nation’s freedom. The flag of the United States represents freedom and has been an enduring symbol of the country’s ideals since its early days. During both events, Americans also remember their loyalty to the nation, reaffirm their belief in liberty and justice, and observe the nation’s unity. Although Flag Day is a nationwide observance, it is not a public holiday in many parts of the United States. It is a legal holiday in a few areas in the USA, such as Montour County in Pennsylvania.
June is Dysphagia Awareness Month
Don’t forget to spread the news throughout social media
and use #dysphagiaawareness so all can be aware of this debilitating disorder.
How are you helping recognize dysphagia awareness month?
The best way to celebrate this month is to educate!
Follow DiagnosTEX on
DiagnosTEX CE Conference in May – We had a great turnout, so wonderful to see everyone!
Thank you for all the GREAT comments, compliments, support and high scores on the TSHA evaluation form! Only one lower score, as they commented that they felt my “passion” was distracting. I will plead guilty to passion. Thank you for spending all day Friday with us, look forward to seeing you all again soon!
Our local SLP feature month! We have started a new feature to the newsletter by highlighting some of our great SLP’s in DFW! For June we would like to feature Lindsey Barnes, who has impressed the DiagnosTEX teams with her commitment to her patients and her willingness to learn and ask questions. Lindsey was interviewed by one of our SLP’s so we could get to know her a little better and we want to introduce you to her. Lindsey is a local girl, born in Grand Prairie, grew up in Mansfield and graduated with her degree from Texas State. She has been practicing for 3 years in the field of Speech Pathology. She has used DiagnosTEX services for 2 years. Her favorite population to treat is the neuro geriatric patients. She supports the charities of autism, as this is close to her heart with a cousin who is autistic. In her spare time she loves fixing up her house and enjoys time at the lake and as most native born Texans, she loves Mexican food. When asked what her bucket list included, it was to advance her career, take on CF’s and develop new programs. This is why we love Lindsey! We are so blessed to be a part of her dysphagia management team and are thankful for her support and trust in us! She is an asset to our field.
This month DiagnosTEX Is handing out a comprehensive educational sheet on MBSS for patients and families in recognition of Dysphagia Awareness Month – Get your copy next time we see you! Other handouts can be found at the Clinical Café on our website www.dysphagiadiagnostex.com .
Final 2016 QA results for DiagnosTEX – Each year we complete Quality Assurance (QA) on patients seen in one month. This MBSS QA shows a cost savings to healthcare in many levels including the ability to develop an appropriate treatment plan, improve discharge rates, reduce alternate means of feeding and reduce dysphagia risks. We have shared these results with many government level committees and national organizations over the years since we started this in 2003. This year we followed up on 408 patients in October, with 97% of the documented cases conferred. Thank you to ALL those who answered our calls and called us back during the QA follow up! We really do appreciate those who respect what we are trying to do and help us out every year. This is always so much fun to actually see all the final statistics:
- Of the 408 patients, 70% were recommended for a PO diet and only 28% recommended for NPO.
- Thin liquid was the most recommended liquid consistency with only 23% recommended for nectar or honey.
- Out of 408 studies, 169 patients aspirated and 139 of those were silent aspirators.
- Out of 281 patients examined in AP, 41% showed some form of esophageal involvement in their dysphagia.
- Out of the 408 patients, 218 of those were given compensatory strategies to ensure safe and efficient PO.
- Percentage of discharge rates were at 60% after the MBSS.
- There were 20% of cases that signed an AMA. Of those discharged from treatment, 7 were discharged to hospice, 31 discharged home, 11 discharged to another facility, 19 discharged to the hospital and 15 patients expired.
Dysphagia Tidbit – Dysphagia Screenings Need Improvement – A recent Canadian study revealed that the majority of stroke patients do not get screened for dysphagia within the first 72-hours of hospitalization; in fact, only 1 in 5 patients received the recommended swallowing screening. Under widely endorsed treatment guidelines, stroke patients are supposed to be screened for what’s known as dysphagia, or an inability to swallow, before they receive any food or drink. Stroke patients with dysphagia have a higher risk of pneumonia, dehydration, disability and death than people who don’t have difficulty swallowing, previous research has shown. For the current study, researchers examined data on 6,677 patients hospitalized with ischemic stroke, which results from an obstruction in a blood vessel supplying the brain .None of the patients were getting support like feeding or breathing tubes that would make them ineligible for dysphagia screening. Within 72 hours of arriving at the hospital, 1,280 patients, or about 19 percent, didn’t get screened, researchers report in Stroke. Omission of screening mainly occurs in patients with mild strokes, who are only half as likely as patients with more severe strokes to receive screening, said lead study author Dr. Raed Joundi, a neurology researcher at the University of Toronto. Failing a dysphagia screening test increases the risk of poor outcomes — including death, disability, complications — as much as other major prognostic factors like older age and severe stroke, and is true even in people with mild strokes, Joundi said by email. Elderly people who were at least 80 years old were 44 percent more likely to get checked for dysphagia than patients under 60. People admitted to the intensive care unit were 56 percent more likely to receive screening, and patients on a stroke unit had more than double the likelihood compared to those on a regular ward. Among the 5,144 patients who had a documented dysphagia screening in their medical records, nearly half failed the test. After a severe stroke, 83 percent of patients failed dysphagia screening, compared with 63 percent of patients who had moderate stroke and 33 percent with mild stroke. Individuals who failed the screening tended to be older and have more chronic medical issues including dementia prior to the stroke. When they failed the tests, patients were more than four times as likely to develop pneumonia. They also had more than five times the odds of severe disability and were more than twice as likely to be sent to a nursing home or rehabilitation facility after they left the hospital. One limitation of the study is that medical records might have failed to document screenings done for some patients or any tests done outside the 72-hour window examined, the authors note. Still, it’s likely the results would be similar for patients outside of Canada and for people who have less common hemorrhagic stroke, which occurs when a weakened blood vessel ruptures, Joundi said. And the findings suggest that screening efforts need improvement, said Dr. Daniel Lackland, a neurology researcher at the Medical University of South Carolina in Charleston who wasn’t involved in the study.