Imagine if you needed someone to help you eat at every meal or if you are at risk of falling.
The Silver Spoons Dysphagia Management Program
Riverview Health Centre's Interdisciplinary Dysphagia Team has developed a creative, comprehensive approach to prevent and successfully manage problems associated with dysphagia (or difficulty swallowing). By addressing dysphagia, the Team hopes to reduce the incidence of its harmful effects on health, including malnutrition, dehydration, choking and aspiration, which can lead to pneumonia. The Team is composed of a speech-language pathologist, a clinical dietitian, an occupational therapist and a nurse.
At Riverview, the admitting nurse screens each new patient or resident for swallowing problems. Those individuals who show signs of swallowing problems are assessed by the staff speech-language pathologist, who provides recommendations in consultation with the health care team.
Pink Silver Spoons Club decals are used to identify patients and residents with dysphagia. When appropriate, a Safe Swallowing Guide is prepared for an identified patient or resident. This guide provides individualized instructions to ensure safety and adequate nutritional intake at mealtimes.
All nurses and health care aides receive certification in the Silver Spoons Dysphagia Management Program (SSDMP). Self-study and an orientation in-service session provide an opportunity to learn about and practise safe feeding techniques. The purpose of the education program is to provide staff with the knowledge they need to help prevent problems related to dysphagia. Plans are underway to expand education in the SSDMP to family members, caregivers, volunteers and non-nursing staff at Riverview.
Falls Management and Prevention Program At Riverview Health Centre
Falls occur among people of all ages, but most frequently affect older persons. Falls and related injuries result in profound human suffering and enormous health care costs.
One way to reduce the occurrence of falls is through the development of a fall prevention program. If we can predict who is at highest risk for falling, we can then take steps to prevent falls or the injuries caused by them.
While Riverview Health Centre (in conjunction with the Nursing Quality Improvement Committee and the Clinical Nurse Specialist), has made fall prevention and management one of its major focuses since the 1990's, in 2002 the program was revised to promote a systematic, formalized, interdisciplinary patient-centered approach that focuses on risk assessment, use of environmental cues (falls decal), preventive interventions, staff and patient/resident/family education (including a brochure), clinical protocols and care plans, as well as quality monitoring. The goals of the program are to reduce the number of falls and their severity while acknowledging that as patients/residents strive to maintain their autonomy and independence in a least restraint environment, the occurrence of falls cannot be completely eradicated.
The Fall Prevention and Management program is introduced to staff at orientation, and the Intranet contains updated information on the program and its components so that staff have access to timely information. The program is continually evaluated to determine its effectiveness and its appropriateness for particular sets of patients/residents at Riverview Health Centre. Appropriate changes to the program are made in response to changing patient/resident situations, including most recently the introduction of various bed exit alarm systems, the use of low to floor beds, and various new best practice initiatives, e.g., frequent rounding.