Lecture 10

Question 1

What is the Joseph Murray Quote?

Answer 1

Can this person safely eat? In our zeal to report specific findings, we think are relevant, we may dismiss the physicians explicit question, leaving the physician feeling like something is missing.

Question 2

What is needed in documentation in regards to Dysphagia?

Answer 2

• exactly how many trials
• what substances used
• the success or lack thereof at each stage of swallowing.

Question 3

What is the Dr. most concerned about seeing on a dysphagia report?

Answer 3

Whether the pt. will be NPO or PO

Question 4

What are the primary goals fordiagnostic reports?

Answer 4

1. Provide a permanent record

2. Facilitate communication

Question 5

What are additional goals on a diagnostic report?

Answer 5

1. Provide info relevant to dx
2. Evaluate a course of tx
3. Document abilities a different stages of a disease
4. Advocate for your pt.

Question 6

What is extra information you should include on a diagnostic report?

Answer 6

whether or not the person is going to be safe with po intake
(relative to that, our primary goals are going to be to provide a record of the patient’s status and their abilities/ deficits at the time that you evaluated them)

Question 7

In a medical setting who do SLPs communicate with in regards to dysphagia pts?

Answer 7

physician
possibly another SLP
a family member
support staff 
pt

Question 8

In a school setting who do SLPs communicate with in regards to dysphagia pts?

Answer 8

classroom teacher
auxiliary personnel( OT)
supervisors at lunchtime/ snack time

Question 9

What specific info may help with a dx of a dysphagia pts?

Answer 9

where there is presence or absence of dysphasia

Question 10

What specific info may help with a dx in a pt with a progressive disease?

Answer 10

whether or not a patient is demonstrating typical or an atypical

Question 11

When reporting about specific txs what should you include?

Answer 11

Ex. (With e-stim or oral motor exercises or the use of particular postures then you’re going to need to provide information about how effective those treatments seem to be for keeping that individual safe.
-You will also want to establish a record of how an individual progresses through the stages of a progressive disease like ALS, Parkinson’s etc.
You want to keep a record and stay on
top of how safe does the person continue to be.

Question 12

Who is usually the advocate in a school setting with a student who has dysphagia?

Answer 12

The SLP

Question 13

When an error is made on a medical document, what is the most common procedure to notate this error?

Answer 13

medical professionals use a single thin line to cross out

something that is written by hand that was incorrect and the writer then writes their initials next to it.

Question 14

What are productivity restraints?

Answer 14

• how long we have to evaluate a patient
• how we do treatment with a patient
• how the facility will be reimbursed for your services

Question 15

What does productivity include in medical facilities?

Answer 15

• percentage of the hours that you are on-site and are actually with the patient
• does not include enough time to write assessment reports

Question 16

What is a benefit of electronic medical records?

Answer 16

Allows you to write in narrative form about the patient, but also to benefit from the
time-saving checklists and pull down menus.

Question 17

What should be listed on a diagnostic report but usually isn’t?

Answer 17

-hearing loss, hearing aids, glasses
-whether pt is bilingual
- include nformation that’s relevant to the work that you do
-also explain if pt’s swallowing mechanism works okay or not due to their cognitive factors
(list examples like, can follow directions or not)
- If pt. has aphasia note behavior on if patient is cooperative or not, or if they are very alert most of the time or not, or impulsivity

Question 18

What should the history section include?

Answer 18

what kind of a diet the patient was eating before

-what kind of a diet the patient is eating right

Question 19

On clinical swallow assessments, what are things that should be notated about?

Answer 19

• Factors you are looking at. Ex. own secretions, 1st substance administered
• Aspects of the oral stage Ex. chewing, residual material, swallow complete or not
• Pharygneal phase: Ex. initiation of the swallow response, elevation impaired, cough with clear throat after swallow or wet voice
• Use of cervical auscultation
• C/T could not test or DNT did not test
• could not test means that the patient had a seizure or a heart attack, temper tantrum etc.
• DNT just means you didn’t included it in your notes
• Documentation of findings, is pt good for tx, did you provide education to family, pt and staff of facility

Question 20

What are negative factors that you may include on a diagnostic report?

Answer 20

for later stages of a progressive disease including dementia , so it we don’t think that there are huge gains to be made for somebody who has a who is in the latter stages of a progressive dementia we would notate that.

Question 21

On a diagnostic report you should lead with what?

Answer 21

a summary statement that other medical provide care providers and family actually want know.

Question 22

In regards to substances, how should you notate information here?

Answer 22

With Specific substances:
Ex. there was moderate coughing with thin liquids no overt signs of penetration or aspiration with thickened liquids puree or solids, include something about a sort of a summary statement about whether or not the person is safe for po.

Question 23

What should a diagnostic swallowing report end with?

Answer 23

A set up statement, recommendations, comments on a VFSS or MBS and recommendations and whether the pt is either NPO with NPO and medications and if they are to be delivered orally

Question 24

Should you state how often a tx is?

Answer 24

Yes

Question 25

Is the results section just facts?

Answer 25

Yes

Question 26

What are grimaces maxims?

Answer 26

Maxims of quantity
1 Make your contribution to the conv as informative as necessary
2 Do not make your contribution to the conv more informative than necessary

Maxims of quality
1 Do not say what you believe to be false
2 Do not say that for which you lack adequate evidence.