Use of thickened liquids in skilled nursing facilities.
OBJECTIVE
Long-term care residents are routinely provided with thickened liquids for the management of dysphagia. The objective of this study was to identify the prevalence of thickened liquid use in skilled nursing facilities.


METHODS
Facility-wide data were provided by staff at 252 randomly selected skilled nursing facilities owned by 11 multifacility providers. The sample represented 25,470 residents and approximately 20% of all freestanding skilled nursing facilities nationwide.


METHODS
Data regarding prevalence of thickened liquid use and facility characteristics were collected during May 2002. Statistical analysis Descriptive statistics included national and regional averages and national percentile distributions.


RESULTS
A mean of 8.3% (range 0% to 28%) of residents were receiving thickened liquids, with considerable variation between Centers for Medicare and Medicaid Services regions. Of those receiving thickened liquids, on average 60% received "nectar/syrup" thick, 33% received "honey" thick, and 6% received "pudding/spoon" thick, although the frequencies with which each thickness was prescribed varied widely between facilities (range 0% to 100%). Thickened water was provided to residents in 91.6% of facilities. Nationally, registered dietitian staffing levels were lower on average than speech language pathologist staffing levels.


CONCLUSIONS
Thickened liquids are provided to a significant segment of the skilled nursing facility resident population. In the absence of outcomes-based practice standards to guide administrative decisions related to the provision of thickened liquids, dietetics professionals may find regional and national norms helpful for quality assurance processes and to inform resource management decisions in clinical staffing and foodservice.
Department of Dietetics and Nutrition, and Long Term Care Institute, National Policy and Resource Center on Nutrition and Aging, Florida International University, Miami, 33199, USA. castellv@fiu.edu
Victoria H
VH
Castellanos
Ellen
E
Butler
Lynda
L
Gluch
Brigitte
B
Burke
D003625:Data Collection; D003680:Deglutition Disorders / Q000178:diet therapy*; D004046:Dietetics / Q000592:standards*; D005522:Food Services / Q000592:standards*; D005526:Food, Formulated / Q000706:statistics & numerical data*; D006801:Humans; D008134:Long-Term Care; D009740:Nursing Staff; D011787:Quality of Health Care; D012016:Reference Values; D012866:Skilled Nursing Facilities / Q000592:standards*; D014481:United States; D014783:Viscosity