top of page
Search

Enhancing Quality and Safety through Collaborative, Inter-professional Management of Dysphagia.

Updated: Mar 24

With approximately 8% of the global population experiencing dysphagia, there's a significant need for personalised support to ensure safety, adequate nutrition, and hydration. In November 2020, the National Disability Insurance Scheme (NDIS) Quality and Safeguards Commission issued an alert highlighting the importance of safe swallowing and meal-time management. This blog summarises that alert and provides practical guidance for healthcare workers and caregivers managing dysphagia.

Understanding Dysphagia:


Dysphagia is a medical term describing difficulties with swallowing. This condition may arise from various disabilities or medical issues, including:

  • Neuromuscular dysfunction (e.g., cerebral palsy)

  • Congenital syndromes

  • Neurological conditions (e.g., stroke)

  • Conditions such as cancer and chronic lung disease

Identifying Dysphagia: Signs and Symptoms

Recognising dysphagia early can significantly reduce risks and enhance patient safety. Common symptoms include:

  • Difficulty or pain when chewing or swallowing

  • Trouble controlling food or liquid in the mouth

  • Sensation of food being stuck or going down incorrectly

  • Frequent coughing, choking, or throat clearing during meals

  • Meals extending beyond 30 minutes

  • Shortness of breath during eating or drinking

  • Avoidance of specific foods

  • Vomiting or spitting out undigested food

  • Excessive drooling

  • Hoarse or gurgly voice

  • Dry mouth

  • Poor oral hygiene

  • Frequent heartburn

  • Unintended weight loss

  • Recurrent respiratory infections

Recommended Best Practices

Risks associated with dysphagia include choking and aspiration pneumonia, which can lead to severe health consequences, including death. Effective dysphagia management requires a collaborative team approach involving:

Speech Pathologist:

  • Assesses swallowing abilities and recommends appropriate diet modifications and fluid consistencies.

  • Determines frequency for review and outlines when additional assessments may be required.

General Practitioner (GP):

  • Monitors overall health, swallowing challenges, and recommends appropriate treatments.

  • Ensures regular medication reviews.

Dietitian:

  • Assures that dietary modifications meet nutritional and hydration needs.

Other professionals who might be involved include Dentists, Pharmacists, Ambulance personnel, Occupational Therapists, and Physiotherapists, based on the participant’s specific needs.

Roles and Responsibilities of Support Staff

Staff directly supporting individuals with dysphagia should:

  • Implement strategies outlined in the participant’s mealtime management plan.

  • Complete organisational training on dysphagia.

  • Continuously improve their knowledge and skills related to dysphagia.

  • Monitor individuals closely, noting new signs or changes in symptoms.

  • Manage incidents like choking or aspiration pneumonia swiftly through appropriate first aid, referrals, and detailed documentation (incident reports, progress notes).

  • Uphold high levels of professionalism, empathy, and compassion.

  • Adhere to the NDIS Code of Conduct at all times.

Provider Obligations

Providers must:

  • Comply fully with the NDIS Code of Conduct and practice standards.

  • Ensure all participants have an individualised mealtime management plan detailing:

    • Appropriate seating positions.

    • Modifications to food textures and fluids.

    • Specific meal assistance techniques.

    • Emergency response protocols for choking incidents.

    • Use of adaptive feeding equipment.

  • Regularly review and update meal plans.

  • Train staff adequately, ensuring trained personnel are always available.

  • Foster regular discussions on dysphagia safety during staff meetings.

Compliance and Standards

Compliance with the NDIS Code of Conduct and Practice Standards is mandatory. Providers and staff must:

  • Deliver high-quality, safe, compassionate care.

  • Promptly identify and address concerns affecting quality and safety.

Relevant NDIS Practice Standards include:

  • Human Resource Management

  • Access to Appropriate Supports

  • Safe Environment for Supports

  • Risk Management

  • Quality Management

  • Information Management

  • Incident Management

Conclusion

Effectively managing dysphagia relies heavily on collaboration among inter-professional teams. Providers and staff working together ensure participants receive consistent, safe, and high-quality care, aligned with NDIS guidelines and practice standards. Through continuous education, proactive risk management, and adherence to individualised care plans, the safety and wellbeing of people with dysphagia are significantly enhanced.


You can read more about Inter Professional Learning here.


References:

2. The NDIS code of conduct

3. Workers can access free e-learning material easily by following link below.

Comments

bottom of page