[Dysphagia] writing orders

[plarghi at msn.com (Patti Larghi)]

I think this topic has been addressed on this list serve before but I would 
like to reviist it.  I work in an acute care hospital setting. I am often 
faced with the problem of making a simple diet texture and or liquid 
consistency adjustment by obtaining a telephone order from a difficult to 
reach physician. It has always been my understanding that this can only be 
done with a physician's order and physicians are the only ones allowed to 
write orders.That being said our dietary department recently wrote a policy 
stating that a registered dietician could adjust diet texture or write 
orders for supplements. This was approved by the Pharmacy and Therapeutics 
Comittee and then by the Medical Review Board.
Orders are now written by dietician to adjust diet textures, po supplements 
etc. This is only after a diet has been intiated by the physician.
I would like to do something similiar to this which would allow the Speech 
Pathologists to write orders to change the texture of an existing diet and 
the viscosity level of  liquids. This would be referenced to the national 
dysphagia diet standards.
Now for the question. Has any one had success with implementing this type of 
protocal?  I realize we all  have physicans  that we work with regularly 
which give us blanket telephone orders priviledges,but I would like to make 
this avaliable as a protocal which pertains specifically to the SLP staff to 
make this change independently.
Thanks in advance for any feed back.
Patti Larghi
Speech Pathologist
Memomrial Health Care System