Are Nursing Staff Achieving Accurate Consistencies of Thickened Fluids Following IDDSI Implementation and What Factors Do They Perceive to Influence This? An Extended Proposal

Abstract

Thickened fluids are a popular management method for dysphagia as thicker fluids move more slowly meaning individuals with dysphagia have more time to protect their airway. However, research has shown that nursing staff do not always achieve accurate consistencies when thickening fluids and this can have negative impacts on patients’ health, including dehydration if fluids are too thick, and aspiration which can result in a chest infection if fluids are too thin, or too thick. It was proposed that the provision of consistent terminology would be a potential solution to this issue, and therefore the International Dysphagia Diet Standardisation Initiative (IDDSI) was introduced to provide globally standardised terminology for thickened fluid consistencies. The first phase of the proposed study intends to use a descriptive, non-experimental design to observe the percentage of fluids thickened inaccurately by nursing staff. There are other factors aside from inconsistent terminology that could impact upon the accuracy of consistency of thickened fluids such as subjective measurements used to check consistency, a lack of training in how to thicken fluids, a lack of understanding for the rationale of thickened fluids and a lack of compliance with recommendations for thickener. Therefore, the second phase of the proposed study will use interpretative phenomenological analysis to interview nursing staff to acquire their perspectives on factors that they feel affect their ability, competence and willingness to thicken fluids to accurate consistencies, as well as their opinion on the implementation of IDDSI within their setting. Results from this mixed methods study will suggest how often fluids are thickened to inaccurate consistencies by nursing staff and suggest what factors are influencing this. By gaining this knowledge, actions can be proposed that are likely to improve nursing staffs’ ability, competence and willingness to thicken fluids to accurate consistencies.