Evaluating an Algorithm for Prescribing Mildly Thick Liquids as a Temporary Bridge to an Oral Diet in the Acutely...

Objective This study aims to evaluate the safety of the temporary use of mildly thick liquids (MTL) prescribed at bedside using a stringent algorithm in hospitalized patients.  Study design This retrospective chart review study included hospitalized patients who had a consultation with speech pathology for clinical swallow evaluation and were given diet recommendations of MTL. Exclusion criteria involved patients who were initially seen for an instrumental assessment (not at bedside) and patients who did not receive speech-language pathologist (SLP) follow-up (due to a change in medical status, diet managed by the medical team after initial assessment, etc.) Methods Data from bedside SLP evaluation or instrumental swallow evaluation (modified barium swallow study (MBSS) or fiberoptic endoscopic evaluation of swallowing (FEES)) during hospitalization were collected. Radiologic chest imaging reports from before and after MTL diets were reviewed for possible aspiration or aspiration pneumonia. Descriptive statistical analysis was conducted using Excel. Results Of 1000 charts reviewed, 162 patients met the inclusion and exclusion criteria. Seven of these 162 patients (4.3%) had radiologic findings suggesting concern for aspiration after the MTL diet was prescribed. Six of these patients had medical factors that contributed to the radiologic finding; thus, a direct relationship between MTL diet and concern for aspiration could not be established. Conclusions This study supports consideration of temporary MTL prescribed at bedside with a stringent algorithm, given the small number (4.3%) of patients with aspiration concerns after MTL diet on follow-up. This approach may shorten the time to oral diet and hospital discharge in carefully selected patients.