Shari Bernard, Vicki Loeslie, Jeffrey Rabatin; Use of a Modified Frazier Water Protocol in Critical Illness Survivors With Pulmonary Compromise and Dysphagia: A Pilot Study. Am J Occup Ther 2015;70(1):7001350040. https://doi.org/10.5014/ajot.2016.016857
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Limited information is available regarding use of the Frazier free water protocol (FWP) with hospitalized patients who have dysphagia and have survived a critical illness with compromised pulmonary status. This pilot study used a two-group nonequivalent comparison group design to evaluate the FWP in 15 adults admitted to a respiratory care unit (RCU) with dysphagia concerns. Inclusion criteria included recommendation for a modified diet with thickened liquids by a dysphagia therapist and ability to follow the specific free water guidelines. The 15 control participants were chosen from a retrospective chart review of consecutive RCU admissions that met the same inclusion criteria. The intervention group for whom the free water guidelines were implemented did not differ significantly from the control group in rate of development of aspiration pneumonia, χ2(30) = .01, p = 1.00.
Patients who experience dysphagia and pulmonary compromise after critical illness can have ice chips or sips of water when on a modified diet with no change in risk of developing pneumonia.
The literature provides evidence to support increased compliance with modified diet recommendations and decreased risk of dehydration when free water guidelines are used.
This study supports the use of free water guidelines as an evidence-based intervention for critical illness survivors who have pulmonary compromise.
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