The Frazier Water Protocol?

The frazier water protocol is part of speech therapy.
It allows patients that are on a thicken consistent liquid, drink water.
First the pt is given mouth care and than they are allowed to drink water and water is premitted until the first bite of food then the pt goes back to thickened liquid. Pills are also to be given with thickened liquids.

I first explain it to them, then we give mouth care with a special mouth wash, The frazier water protocol decreases pneumonia increases desire to eat increasesoral awarenes of food and decreases aspiration

Frazier Water Protocol

Policy & Procedure

Rehab Department




POLICY


Frazier Water Protocol states that small amounts of water can safely be administered to residents on Nectar thick and Honey thick liquids between meals only. A physician’s order and SLP treatment is required for all residents who will participate in the Frazier Water Protocol prior to administration of water by nursing staff.

PROCEDURE

1. The human body is about 60 % water and thus small amounts of water taken into the lungs are quickly absorbed into the body pool. Since water has a neutral pH, free water consumption can be encouraged for residents and make a significant contribution to hydration between meals.

2. Aggressive oral care is the key factor in safety with this protocol. Residents are to have oral care the first thing in the morning and the last thing at night. Oral care consists of brushing teeth, tongue, buccal cavity and the roof of the mouth with tooth paste and a tooth brush whenever possible rather than a swab. Additional oral care before and after meals is encouraged whenever feasible.

3. Resident is offered no more than 4 ounces of water between meals with no additional food at the time of water presentations.

4. The manner of presentation of the water may be restricted, e. g. given by teaspoons only.

5. The resident will be supervised by the nursing staff during the water protocol at all times.

6. The resident may NOT have water with meals.

7. The resident may NOT have water with medications.

8. The resident should be sitting in an upright position as near 90 degrees as possible during the entire time of the protocol.

9. The resident may NOT eat food or drink anything else after the water protocol for at least 30 minutes.

10. If excessive coughing starts, stop the water protocol immediately.

I just wrote this policy this week for the protocol. Hope this helps.

Is the oral care done to promote stimulation? Or prevent germs? Or both?

Primarily the oral care is done to reduce the bacteria in the mouth. The bacteria is what can cause the pneumonia, not the water per se. Aggressive oral care is the keynote of the protocol.

I wored on Stroke Unit, Frazier Rehab, Ky. Remember giving water by teaspoons to total ordered amount of water. Took ALOT of teaspoons. Never saw any patient's get aspiration related pneumonia, and it sure kept patient's from obtaining water from toilets, flower pitchers, etc!! I think it actually made them feel better in psychological way, water is one of our basic needs/wants.
I really wish all facilities used this program!!