January 2015 Newsletter
Clinical Café Newsletter
By: Ronda Polansky M.S. CCC-SLP
Happy New Year!
DiagnosTEX will be closed on January 1st and 2nd 2015
2015 DiagnosTEX Dysphagia Calendars are distributed! Thank you for all the great feedback! So much fun to know how much they are anticipated for each year!
Popular New Years Resolutions – A study by Richard Wiseman from the University of Bristol involving 3,000 people showed that 88% of those who set New Year resolutions fail, despite the fact that 52% of the study’s participants were confident of success at the beginning. Men achieved their goal 22% more often when they engaged in goal setting, (a system where small measurable goals are being set; such as, a pound a week, instead of saying “lose weight”), while women succeeded 10% more when they made their goals public and got support from their friends
- Improve physical well-being: eat healthy food, lose weight, exercise more, eat better, drink less alcohol, quit smoking, stop biting nails, get rid of old bad habits
- Improve mental well-being: think positive, laugh more often, enjoy life, spend more time with family, be more spiritual, be nicer to people.
- Improve finances: get out of debt, save money, make small investments
- Improve self: become more organized, reduce stress, be less grumpy, manage time, be more independent, perhaps watch less television, play fewer sitting-down video games
- Take a trip
- Volunteer to help others, practice life skills, use civic virtue, give to charity, volunteer to work part-time in a charity organization (NGO)
2014 QA – Quality Assurance – Thank you to all of you who spoke with us during the day and also tolerated our phone calls, but especially for calling us back after we left voice messages. We appreciate all of those who took the time to return our call and talk with us briefly! The follow up on the patients we evaluated is important to us and this information has been so helpful to us over the years, not only as a company, but to our profession at a national level. We have shared the numbers/percentages of our QA with ASHA, Medicare, and Healthcare Reform Committee. MANY thanks to those of you who also saw the benefit and were willing to work with us collecting the data on your patients, as this benefits us all in the long run! We will share the results with you when we get it complete. They are always so interesting!
Interesting 2014 ASHA STATS
– 79% of ASHA hospital based professionals regularly treat people with swallowing disorders
– 62% of ASHA SLP’s indicated that they are interested in reading about swallowing disorders
– 90% of ASHA SLP’s working in health-care setting provide primary swallowing services
– 56% of the SLP’s are involved in purchasing dysphagia products.
Parking for the mobile MBSS- In our service agreement it states that the facility will provide DiagnosTEX a place to park to see the patient referred to us. This place needs to be on the facility grounds and in a safe and accessible location to transport patients to and from the mobile clinic. We will not park on a busy street, nor will we park across the street from the facility if the parking lot is full. We are a mobile doctor’s office and taking the patient around a building to the back next to the dumpsters, is not ideal for us or the patient and their families, as this does not represent the importance of this exam. If we arrive at the facility and cannot find a place to park to complete the exam with the assistance of the facility staff, the facility will be charged a cancellation fee and we will reschedule the patient for another day.
January CEU – A great way to start off the new year! Do more in 30 minutes of dysphagia treatment with the Ampcare ESP™ System. Check out the details on the upcoming Fort Worth course on January 24th at www.ampcarellc.com .
Dysphagia Tidbit –A diagnosis of dysphagia – To have dysphagia, you must have dysphagia
When reviewing a medical record look for the following information as part of your evaluation:
- What was the patient’s swallowing baseline – Use the chart and be a detective, if any of you have attended my previous DSI course, we are all a part of the Dysphagia Scene Investigation.
- Is there a procedure that could have caused a dysphagia: Lung surgery, cardiothoracic surgery, head and neck cancer surgery, esophagus surgery, tracheostomy, cervical spine surgery, etc.
- Is there a spread of infection: Sepsis, the lungs are not the only source of primary infection, there is also wound, oral cavity, urinary tract. Is this an acute dysphagia due to the current illness or is this short term problem?
- What medical procedure could have caused the dysphagia? Feeding tubes, intubation, extubation, chemo/radiation etc.
- Are there medications that could be causing dysphagia. Poly-pharmacy is a common trend in the geriatric community, check their meds. Believe it or not patients who received antipsychotics are 60% more likely to have a pneumonia (Knol, et al, 2006)
Answers to all these questions greatly effect and impact how we evaluate. This is why it is so import to us that you fill out the Consult/HX forms in their entirety, leaving no blanks.
Example: Patient develops UTI, she feels sleepy or fatigued all day, PO intake drops, this increases severity of her UTI and this results in dehydration. Dehydration causes electrolyte imbalances which leads to some confusion and more infection which leads to more lethargy and a cognitive change. Antipsycotic meds are ordered to control some mild agitation. Patient progresses to being septic and the infection spreads. Her urosepsis spreads and now she has a pneumonia, aspiration risk increases due to this new diagnosis. Without a thorough history and medical chart review, the patient will likely be labeled with a dysphagia related to the pneumonia and is put on puree and thickened liquids. Will she fall into that category forever or as she improves will someone read the chart find this information, connect the details and history, re-evaluate and discover that her dysphagia was resolved? Use the chart and all the information it has for you in your evaluation of the patient.
The winner of DiagnosTEX’s January documentation contest is: MaryKate at Garden Terrace in Fort Worth
CONGRATULATIONS for being so diligent in filling out your Consult/Hx forms 100% leaving no blanks!