[Dysphagia] Autonomy & Orders

[emilymoretz at yahoo.com (Emily Wells)]

I know there has been discussion in the past regarding orders, but I am curious about the protocols, expectations, cultures within different hospitals. I'm trying to collect some data to present, with hopes of allowing patients to receive more timely services (vs awaiting every single specific order from a physician).  I work in a hospital at which individual orders must be obtained for EVERYTHING (if we are consulted for "aphasia", we must obtain a separate order for swallowing if we notice, by chance, dysphagia while doing our assessment) - this standard per the rehab manager. FYI: in this same hospital, registered dietitians and nurses do have the privilege to write orders. SLPs cannot, due to our immediate management stating that this is a "slippery slope." I won't take out my personal frustration on this forum, but would appreciate data.
   
  In your hospitals, what are the processes for obtaining orders for:
  1. MBS/FEES
  2. Diet initiation or NPO
  3. Diet upgrade/downgrade
  4. Passy-Muir evaluation, or placement
  5. Speech/Language/Cog eval (if initial MD order is for swallow eval, or vice versa)
   
  Thanks!
  Emily


 
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