Patient suitability for free water protocols in acute stroke and general medicine: a qualitative study of clinician perceptions

CONCLUSIONS & IMPLICATIONS: Despite the benefits of FWPs in other settings, in acute stroke and general medicine, clinicians erred on the side of safety and, in most cases, would not implement an FWP. Future clinical research is needed to systematically design high-quality and feasible clinical trials to determine the benefits and safety of FWPs for patients with dysphagia in these settings. This would lay the foundations for guidelines to support the complex clinical decision-making regarding patient suitability for FWPs.WHAT THIS PAPER ADDS: What is already known on the subject FWPs are an alternate management strategy for patients with dysphagia, with systematic reviews recommending their use for adults in inpatient rehabilitation with a low risk of pneumonia. However, evidence from the acute setting is sparse, leaving clinicians unsure about which patients might benefit and which may inadvertently be exposed to increased risk by an FWP. What this paper adds to existing knowledge Participants from all interviewed disciplines agreed that SLPs lead the decision-making process and as such act as 'gatekeepers' for access to an FWP. The decision-making process is complex, and participants acknowledged that disease conditions and illnesses were often used as exclusionary criteria. Although participants reported favourably on the benefits of FWPs, their decision-making privileged risk aversion over patient preference in most settings, except for palliative care. Lack of clinical ...
Source: International Journal of Language and Communication Disorders - Category: Speech-Language Pathology Authors: Source Type: research