Aspiration Precaution

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I had a patient on aspiration precautions -- head of bed at 45 degrees, thickened liquids. A nurse reported me one shift for leaving thickened liquids for him at his bedside table while he was in bed at 45 degrees. There was no order for supervised meals or supervised sips. So, if there was no order for supervision, should I still not have done this? As long as he was sitting up and drinking thickened liquids, I thought he was fine to be unsupervised. Is it just a known thing that if there are aspiration precautions, that they are also supervised at all times for consumption?

Thanks!

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Is there an in-house speech therapist? Clarify with them? Talk to unit manager and discuss the issue. Were there orders that indirectly called for supervision like no straw, remind patient to swallow 3 times, check for speech quality, etc?

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On 1/24/2020 at 4:02 PM, Rachel123321 said:

I had a patient on aspiration precautions -- head of bed at 45 degrees, thickened liquids. A nurse reported me one shift for leaving thickened liquids for him at his bedside table while he was in bed at 45 degrees. There was no order for supervised meals or supervised sips. So, if there was no order for supervision, should I still not have done this? As long as he was sitting up and drinking thickened liquids, I thought he was fine to be unsupervised. Is it just a known thing that if there are aspiration precautions, that they are also supervised at all times for consumption?

Thanks!

I have no idea! I know aspiration can be extremely serious, even deadly.

So many issues here.

Did the patient drink the liquids without any problems?

What did whomever the nurse report you to say? Ideally the nurse or her supervisor should have used this as a teaching lesson.

If it is a policy that every patient on aspiration precautions must be supervised while eating, every patient care worker should be told this during orientation, and a sign placed over the patient's bed.

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Specializes in acutecarefloatpool. BSN/RN/CMSRN. i dabble in pedi.

If the patient is alert and oriented, is able to elevated the HOB themselves, and has been educated on the fact that the HOB must be at 90 degrees with eating/drinking I see no problem with it.

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I don't see any problems with this, if patient is able to swallow safely and not confused, if you followed recommended guidelines of head of bed and etc. but usually I sit them up all the way.

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