Safe swallowing of oral liquid medications in patients with dysphagia: A patient quality and safety initiative

Rationale: Patients with oropharyngeal dysphagia are at aspiration risk, making the administration of oral medications challenging. Liquid medications may be too thin and the use of xantham gum based thickeners for liquid medications has not been evaluated. Objectives: This project sought to: •classify the viscosity of commonly prescribed liquid medications •standardize thickening of liquid medications •establish an institution specific collaborative process for thickening liquid medications Study Design and Methods: Viscosity of commonly prescribed liquid medications was visually determined. Next, serial quantities of water (thinnest consistency) were added to applesauce to determine the threshold at which its puree consistency is altered. Finally, medications prescribed in volumes above 10mls were tested with thickening agent. Viscosity of the prepared product was determined using The Line Spread Test. Results: It was determined that up to 2.5 ml of thin liquid added to 16ml of applesauce does not alter the consistency of applesauce. For medications prescribed in volumes greater than 10mls, for which crushable alternatives are not available, recipes with thickener were established. The final consistency attained was pudding thickening (with the exception of Lactulose). Conclusion: Administering liquid medications to patients with oropharyngeal dysphagia is a significant challenge. We developed a standardized approach to the safe and effective administration of liquid medications. (Table Presented) .