Success Story #1
We would like to shine a spotlight on Nicholas Ramano SLP CCC from Freedom Pointe at the Villages. Nick’s dedication to his patients, and his commitment to deliver quality therapeutic intervention and care prompts him to refer patients to DMS for the DST when a high risk is identified. Recently, one of Nick’s patients was living at home and consuming a regular textured diet and thin liquids. The patient’s spouse reported ongoing vocal changes over the previous few months. In Jan ’16, the patient was admitted to Freedom Pointe in the Villages, FL, with a diagnosis of Parkinson’s Disease and UTI/sepsis. Upon completing a bedside evaluation, Nick observed signs and symptoms of aspiration and made a DST referral. During the DST, the patient had consistent penetration of thin liquids along with apparent backflow and residue resting on the esophageal inlet. Tammi Nokes, the DMS SLP recommended a change to a mechanical soft diet and nectar liquid. Tammi and Nick worked closely together over the course of the next few months to increase the patient’s safety. Nick utilized a variety of treatment modalities to increase pharyngeal and laryngeal strength, and referred to DMS for two more follow-up DSTs which eventually resulted in a recommendation of a regular textured diet with nectar liquid. The patient’s GI issues were addressed and eventually he had no backflow evident, with minimal residue resting on the esophageal inlet. Thanks to Nick’s dedication to his patient’s safety, his expertise as an excellent SLP, and his collaboration with DMS to reduce risk, the patient was able to return home on a safe and least restrictive diet. A Job Well Done, Nick!!!
Success Story #2
We are so happy to celebrate the work of Kristen, a practicing Speech Language Pathologist living in Atlanta, Georgia. She works in a skilled nursing facility in the Buckhead, Georgia area, for the past several years. Kristen’s dedication to her patients and her commitment to delivering quality therapeutic recommendation prompts her to refer her patients to DMS for the DST. Recently, a patient was admitted to Kristen’s facility with a diagnosis of pneumonia and respiratory failure. While reviewing the patient’s chart, Kristen noticed the patient had a MBSS one day before admission to the SNF, which cleared the patient for regular diet and thin liquids. Upon evaluation, Kristen observed overt signs and symptoms of aspiration and made a DST referral. During the DST, the patient tolerated the first few trials with no aspiration, however, after 3min the patient began to fatigue. At that time, the patient started to silently aspirate all food trial consistencies, and the DST was able to provide effective dysphagia management recommendation. Thanks to Kristen’s dedication to her patient’s safety and foresight to refer the patient for a DMS DST, the patient was placed on a more appropriate diet that reduced their risk of aspiration.
Success Story #3
A referral came in from Capital Nursing and Rehab Center in Raleigh, North Carolina, for a patient that had been hospitalized with a cervical fracture following a fall. When the patient returned to the facility, he showed a significant decline in PO tolerance. The patient was on a mechanical soft and thin liquid consistency and was coughing with all PO. He also had wet/gurgly vocal quality at baseline, and new onset of PNA. Tim Thomas, the Speech Language Pathologist at Capital Nursing and Rehab, immediately requested a DST that revealed repeated silent penetration across all consistencies except nectar thick liquids via spoon sips with a double swallow. This presented a challenge for the entire facility (e.g. Dietary, NSG, caregivers, etc.) to implement and be sure that the patient received proper nutrition and hydration. Tim led the Interdisciplinary Healthcare Team and provided extensive education to everyone involved. Tim worked closely with the kitchen staff to be sure the patient received everything he needed. After about 4 weeks Tim contacted Jan Harris SLP, a DMS Dysphagia Instrumentation Specialist, and requested a follow up DST. She said that she couldn’t believe her eyes and that it was like she was seeing an entirely different patient! The follow up DST recommended PO trials up to mechanical soft solids and thin liquids combined with Speech Therapy. Since then, the patient has been discharged to a home setting with those recommendations. It was because of Tim’s quick identification of his patient’s need for instrumentation along with the collaboration of the entire facility through his leadership that this patient was able to recover from his PNA and make significant progress during his rehab stay!