The FORWARD care bundle – Improving the care of patients feeding at risk

Lang, Alex; Sommerville, Peter; Nightingale, Sarah; Birns, Jonathan

doi:10.1016/j.clnesp.2017.07.048

Cited by 2 publications

(2 citation statements)

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“…The growing importance of decision‐making as a multidisciplinary team is well established within existing clinical guidelines . Within the context of complex feeding decisions, the introduction of a multidisciplinary decision‐making framework and resources has been observed to reduce time patients remained nil by mouth and increased “best interest discussions” by 25% . Greater collaboration within a multidisciplinary team in clinical practice may also address perceived concerns regarding medico‐legal liability within the SLT profession.…”

Section: Discussionmentioning

confidence: 99%

“…25,39 Within the context of complex feeding decisions, the introduction of a multidisciplinary decision-making framework and resources has been observed to reduce time patients remained nil by mouth and increased "best interest discussions" by 25%. 40 Greater collaboration within a multidisciplinary team in clinical practice may also address perceived concerns regarding medico-legal liability within the SLT profession. As described by Kelly and colleagues, 26 decisions in complex ethical and legal contexts that include questions of legal capacity, informed consent, the direction of medical treatment and the right to decline treatment cannot be made by the SLT alone and require collaboration and communication, particularly with medical colleagues.…”

Section: N (%)mentioning

confidence: 99%

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Clinical decision‐making for complex feeding decisions: A national survey of current approaches and perspectives

2019

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Objectives Decision‐making around dysphagia management is becoming increasingly challenging due to the complexity of contexts associated with an ageing population. The current study explores current decision‐making practices used by speech language therapists (SLTs) surrounding contexts related to palliative care, dementia, neuro‐degenerative diseases, guardianship/family decisions, and other issues relevant to ongoing care of individuals with dysphagia. Methods An exploratory prospective electronic survey of SLTs was conducted. A total of 202 respondents were eligible for inclusion. Results Only 55% of respondents reported their workplace had a standard approach to documentation. Only 19% reported their service had a defined policy to support decision‐making, with only 28% reporting the existence of patient information brochures. Conclusion Limited formal guidance or practice standards exist in the setting of complex dysphagia management, which limits the consistency of practice and clinical efficiency. This insight into current practices and perspectives supports the development of clinical guidelines.

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Section: Discussionmentioning

confidence: 99%

Section: N (%)mentioning

confidence: 99%