FORWARD (Feeding via the Oral Route With Acknowledged Risk of Deterioration): evaluation of a novel tool to support patients eating and drinking at risk of aspiration

Sommerville, Peter; Lang, Alex; Archer, Sally; Woodcock, Thomas; Birns, Jonathan

doi:10.1093/ageing/afz050

Cited by 7 publications

(2 citation statements)

References 17 publications

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“…5 These issues will need considerable attention from TPDs, and represent a real challenge in an era when IMT doctors are managing an increasingly multimorbid patient population demanding more time from each inpatient clinical encounter. 11 In planning IMT, the Royal College Physicians (RCP) projected that approximately 70% of physician trainees would apply to a group 1 medical specialty. 4 The results of this survey suggest that a smaller percentage may wish to proceed immediately to a group 1 medical specialty and this has implications for workforce planning.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of training programmes mapped to the new internal medicine curriculum

Birns

Mullender

Balch

et al. 2020

Future Healthcare Journal

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In preparation for the internal medicine training (IMT) programme introduced in 2019, the core medical training (CMT) programme in London was made 'IMT-ready' in 2018 by creating new rotations that reflected the compulsory requirements of the first 2 years of the IMT curriculum, including provision of the requisite number of critical care placements. Core medical trainees completed posts within the 'IMT-ready' programme between August 2018 and August 2019, during which time the trainee experience was evaluated. A total of 497 responses were received. Of these, 96% of trainees were on an 'acute unselected take' on-call rota, 79% were able to attend outpatient clinics, 80% had the opportunity to practise procedural skills and 88% had the opportunity to apply palliative care skills. Clear areas for improvement were identified that predominantly focused on the need to optimise trainee attendance of outpatient clinics and the number of patients seen during an acute take. With respect to future career intentions, only 63% of trainees planned on applying to a group 1 (with general medicine) higher medical specialty. Thematic analysis of trainees in critical care placements highlighted an appreciation of the level of senior support, feeling well integrated into the team, a positive experience of induction and excellent opportunities for performing procedures.

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Section: Discussionmentioning

confidence: 99%

Evaluation of training programmes mapped to the new internal medicine curriculum

Birns

Mullender

Balch

et al. 2020

Future Healthcare Journal

Self Cite

View full text Add to dashboard Cite

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“…The patient was also advised to perform regular oral exercises, including mouth agape, lips pursed, lips extended, and lips pursed again, with 1 series of 15 exercises to be done twice daily to improve swallowing function. Drink water plan [7] : Twice daily, the patient should consume clean water after performing thorough oral care. The total amount of water should be limited to 90 mL each time.…”

Section: Interventionsmentioning

confidence: 99%

Recovery of severe COVID-19 complicated with cerebral infarction: Considerations on a case report

Mao

Jin

et al. 2023

Medicine

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Rationale: The standardization, individualization, and rationalization of intensive care and treatment for severe patients have improved. However, the combination of corona virus disease 2019 (COVID-19) and cerebral infarction presents new challenges beyond routine nursing care.Patient concerns and diagnoses: This paper examines the rehabilitation nursing of patients with both COVID-19 and cerebral infarction as an example. It is necessary to develop a nursing plan for COVID-19 patients and implement early rehabilitation nursing for cerebral infarction patients.Interventions: Timely rehabilitation nursing intervention is essential to enhance treatment outcomes and promote patient rehabilitation. After 20 days of rehabilitation nursing treatment, patients showed significant improvement in visual analogue scale score, drinking test, and upper and lower limb muscle strength.Outcomes: Treatment outcomes for complications, motor function, and daily activities also improved significantly.Lessons: Critical care and rehabilitation specialist care play a positive role in ensuring patient safety and improving their quality of life by adapting measures to local conditions and the timing of care.

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Eating and Drinking with Acknowledged Risks (EDAR) in Older Adults: A Qualitative Study of the Experiences of Clinicians in Japan and the UK

Yoshimatsu,

Markowski,

Smithard

et al. 2024

Dysphagia

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Eating and drinking are fundamental to life. However, older patients are often restricted with oral intake due to feared risk of aspiration. Eating and Drinking with Acknowledged Risks (EDAR) is an alternative process which enables comfort, dignity, and autonomy for these patients. While national guidance has been developed for EDAR in the UK, other ageing societies such as Japan do not have such guidance. To understand the perspectives and experiences of healthcare professionals regarding the complex decision-making process around EDAR we planned a mixed methods study comparing the two countries. This was the qualitative phase of the study. Twelve healthcare professionals (two doctors, nurses and speech and language therapists each in Japan and the UK) participated in semi-structured interviews on their roles and experiences related to EDAR in older adults. We analysed the data thematically, and three themes emerged: (1) healthcare professionals and healthcare systems, (2) priorities in decision-making and (3) relationship with family and patient. There were many similarities but also differences across the countries, in the setting, training and individual experience. Decision-making was shaped by a complex combination of individual, structural and cultural factors, which indicated in the Japanese culture a greater likeliness to defer clinical decision-making and to side with families’ wishes. Healthcare professionals’ experiences and attitudes towards EDAR differed depending on various factors related with the individual and environment. The next quantitative phase of our research aims to establish the mechanism to increase confidence around EDAR in professionals and training options.

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FORWARD (Feeding via the Oral Route With Acknowledged Risk of Deterioration): evaluation of a novel tool to support patients eating and drinking at risk of aspiration

Cited by 7 publications

References 17 publications

Evaluation of training programmes mapped to the new internal medicine curriculum

Evaluation of training programmes mapped to the new internal medicine curriculum

Recovery of severe COVID-19 complicated with cerebral infarction: Considerations on a case report

Eating and Drinking with Acknowledged Risks (EDAR) in Older Adults: A Qualitative Study of the Experiences of Clinicians in Japan and the UK

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