Presentation on theme: "Incidence of pneumonia associated with the Frazier free water protocol"— Presentation transcript:
1Incidence of pneumonia associated with the Frazier free water protocol Francisco Angulo Parker, PGY2UKY PM&R
2Background 47 to 81% of patients with stroke present with dysphagia. Dysphagia is one of the markers for poor prognosis.Association with high risk for aspiration pneumonia.
3Background Frazier free water protocol. Based on hypothesis that absorbed water, if proper oral care involved, is harmless.Widely used.However, no strong evidence of safety.
4ObjectivesSpecific aim #1: To evaluate the incidence of pneumonia associated with the population receiving the Frazier free water protocol.
5ObjectivesSpecific aim #2: To evaluate hydration status with The Frazier Free Water Protocol compared to a control group.
6ObjectivesSpecific aim #3: To evaluate patient’s satisfaction in the group receiving The Frazier Free Water Protocol compared to the control group.
7Study designThis is a prospective, randomized, single- blinded controlled study.Patients will be randomly enrolled to one of the following groups:1) The Frazier Free Water Protocol, or2) Oral hygiene. No free water.
8PopulationN= 80Stroke patients in Cardinal Hill Rehabilitation HospitalEvaluated during hospital stay.
9Inclusion criteriaa) Stroke pt with dysphagia. b) 18 years and older. c) Able to swallow water without demonstrating excessive coughing. d) Able to maintain alertness and arousal to participate in evaluation e) Patients able to elicit a timely/efficient swallow (determined by SLP). f) Able to maintain upright posture.
10Interventions Experimental group: Control group: Receiving the Frazier free water protocol, oral hygiene.Control group:Receiving oral hygiene only.
11Frazier Free Water Protocol Water can be given freely 30 minutes after a mealWater can be given before a meal.
12Oral hygiene Brush teeth at least 2 times a day Suction and clear oral secretionsRinse 3 times a day with peroxide mixed with water
13Tools Modified Barium Swallow test. Evaluate aspiration to different consistencies. Several MBS may be performed during hospitalization.Clinical signs and symptoms
14Outcome measures Chest X-ray. For diagnosis of pneumonia. BMP. Hydration statusVAS. Patient satisfaction
15Preliminary Information IRB approval Jan 2012N= 1
16Obstacles Enrollment. Complexity of patients Comunication Patient unwillingness