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$69.00 USD

98% rating - reviews

0.3  ASHA CEUs

Water Protocols: The Supportive Evidence, The Limited Evidence, And The Importance Of Clinical Judgment #e271


Presenter: Kathy Panther, MS, CCC-SLP, CBIST

This course covers the evolution of water protocols including why they were developed and why they continue to be relevant today.


"I better understand now the research behind Frazier Water Protocol. Course had nice pace, comprehensive review of research with practical application."

– J.N., prior course participant

Read more comments about this course!

Water protocols have long been controversial as dysphagia management practices and likely will continue to be controversial for the foreseeable future. This course covers the evolution of water protocols including why they were developed and why they continue to be relevant today.

Water protocol studies published by clinician researchers as well as supportive literature from the related fields of nutrition, nursing, pulmonology, dentistry and periodontology, and infectious disease are discussed. The integration of the interdisciplinary views of dysphagia, aspiration pneumonia, dehydration, hydration, optimal wellness, and quality of life form the basis for consideration of this humane approach to dysphagia intervention.

Offered for 0.3 CEUs – 3 contact hours.

Course Overview & Run Time

Course Overview – Run Time: 3:15:04

  1. The History of the Frazier Water Protocol
  2. Aspiration Pneumonia Risk
  3. Thickened Liquid Usage
  4. Dehydration and Hydration Management
  5. Quality of Life
  6. Fluid Absorption of the Lung
  7. Evidence Base for Water Protocols
  8. Frazier Water Protocol Methods and Guidelines
  9. Frazier Water Protocol Implementation Strategies
"This course cleared up what the free water protocol is and how it should be used, and also that there is a limited evidence base, which is useful to know in discussions with colleagues. Course explained well the rationale and evidence base (including limitations)."

– F.M., prior course participant

Read more comments about this course!

Content Disclosures

The content of this online CE course does not focus exclusively on any specific proprietary product or service. Presenter financial and non-financial disclosures may be found in the Presenter & Disclosures area.

Course Format

Video PowerPoint presentation with author narration & downloadable handout. Stop and re-start the course at any point. Learners retain access to course content after completion for ongoing reference and review.

Reviews

Comments From Prior Course Participants

"The literature overview and the breakdown of the Fraser water protocol were helpful. I liked the reference to the evidence throughout the presentation and what to consider in case-by-case FWP." C.W. (Dec. 2024)

"It was beneficial to understand the research behind the FWP as this is frequently utilized in the NH I am in." S.S. (Dec. 2024)

"Helpful education regarding oral care and risks for aspiration pneumonia, even if a patient is NPO. I liked learning more about dehydration and its effects on patients' quality of life and health." A.A. (Dec. 2024)

"The information was very thorough. I liked the discussion on understanding the evidence base." S.B. (Dec. 2024)

"The research regarding the higher risks of pneumonia or lung injury due to aspiration of the often recommended thickened liquids versus thin liquids was an eye-opener that will change my practice. The course was comprehensive with great examples and tied all the information together. The presenter is a natural teacher who made the information easy to remember." S.G. (Nov. 2024)

"I liked that the information was evidence-based." C.D. (Nov. 2024)

"I enjoyed learning about the protocols for evaluating and starting a water protocol for my patients in the acute rehab setting. All the research done to evaluate and implement the water program was beneficial." J.S. (Nov. 2024)

"I enjoyed learning specific details about the water protocol." M.C. (Nov. 2024)

"Information about bacteria in water and saliva to highlight the importance of brushing teeth. Ensuring medications are not provided with thickened liquids, but instead pureed items. I enjoyed the duration and content." M.W. (Nov. 2024)

"I provide the water protocol every day to my patient in the home health setting. I liked the ease of listening to this course." A.S. (Nov. 2024)

"Education for pt families and carers. Self-paced, plenty of research and method of protocol." C.S. (Oct. 2024)

"Discussing the dos and don'ts of the FWP was helpful. I enjoyed the history of how FWP came about." L.M. (Oct. 2024)

"The research information was beneficial." B.P. (Aug. 2024)

"Review of the literature was helpful. I liked the thorough explanations." M.B. (Aug. 2024)

"Practical information on rationale for and against thick liquids and water protocols." E.B. (Jun. 2024)

"The evidence and research behind free water protocols were beneficial. I liked that I could take the course at my leisure and rewind as needed." L.V. (May. 2024)

"Dehydration was a beneficial topic. I enjoyed the review of the literature." B.M. (May. 2024)

"Understanding the benefits of offering water to patients on thickened liquids. I enjoyed the research." F.M. (Mar. 2024)

"This was a topic concentration that was practical." S.C. (Dec. 2023)

"Coordination of this information with nursing teams to improve oral care consistency and follow FWP within the established guidelines. I will be more cognizant of allowing free water between meals if a person needs thickened, as shown on MBS. I liked the layout and explanation of the studies that guided the changes in the history of Frazier water protocols." S.C. (Dec. 2023)

"The changes to current beliefs/practice of water protocol were helpful. I liked the course material and ability to stop-start as needed." M.L. (Dec. 2023)

"Discussing the myths about aspiration was beneficial." P.G. (Dec. 2023)

"I liked the evidence-based resources." I.M. (Dec. 2023)

"The water protocol rules were beneficial. The studies discussed were helpful as well." S.D. (Dec. 2023)

"Discussing that free water protocol does not mean that patients are having thin water only, which is what I assumed and what my workplace has been implementing. This course cleared up what the free water protocol is and how it should be used, and also that there is a limited evidence base, which is useful to know in discussions with colleagues. Course explained well the rationale and evidence base (including limitations)." F.M. (Dec. 2023)

"Course was practical. I liked the discussion on dehydration." K.M. (Dec. 2023)

"The resources that can help to support a water protocol were beneficial. The course content was all great!" C.O. (Nov. 2023)

"Learning about the Water Protocol and rationale for use - as a professional with individuals on TL this will be helpful!" K.P. (Nov. 2023)

"The research was beneficial, and I enjoyed the history." C.D. (Nov. 2023)

"The discussion of implementing the actual protocol and the biological rationale for allowing water (but not other beverages) was beneficial. I liked the applicability of the material presented." E.H. (Oct. 2023)

"I liked all the research findings, the history of the water protocol, and the science behind it! Quality of life and how it may make a difference in a patient's ability to enjoy water from all the sensory perspectives was beneficial. I liked how specifically course described when water is appropriate for individuals who are PO and NPO." J.L. (Oct. 2023)

"The speaker was very knowledgeable and presented many studies that were very informative. Discussing the variables that impact whether a patient is likely to develop aspiration pneumonia and how to weigh those variables in clinical decision-making was beneficial." R.P. (Oct. 2023)

"I liked all of it. And the enthusiasm of the presenter for this topic." S.W. (Oct. 2023)

"FWP treatment practices and evidence-based practices were beneficial." A.B. (Aug. 2023)

"Immediate application with up-to-date research. Oral care and information to share with colleagues was beneficial." M.W. (Jun. 2023)

"All of the content was interesting, relevant to clinical practice, easy to listen to, and well-paced. The history and controversy were a really helpful background." E.N. (May 2023)

"Awareness of the importance of considering free water protocol predictors of aspiration pneumonia was a beneficial topic." T.S. (May 2023)

"Learning that thickened liquids might have a negative effect on certain medications. Good discussion on research and lack thereof on water protocol use, and the effects of dehydration." H.K. (Apr. 2023)

"The speaker was easy to listen to. Discussion of water protocols for pts on thickened liquids was beneficial." R.C. (Apr. 2023)

"I liked the research. This course was comprehensive and very easy to follow." J.D. (Mar. 2023)

"Learning better implementation of the FWP with my patients. I liked the guidelines from various studies that have implemented the FWP." J.V. (Mar. 2023)

"Good discussion of difficulty of securing conclusive research funding and other resources. I liked the breakdown of course into short videos, ability to speed/slow speaker voice, and rewind 10 seconds." R.H. (Mar. 2023)

"Very clear examples. I liked all of it." K.G. (Feb. 2023)

"The entire presentation was beneficial. I enjoyed the convenience of this online course." A.W. (Jan. 2023)

"Risk factors for aspiration PNA. A clear breakdown of info." A.B. (Jan. 2023)

"Defined appropriate criteria for free water protocols. Plenty of supporting evidence and balanced consideration of the evidence." K.W. (Jan. 2023)

"Liked the open discussion on the topic of allowing patients to have water. Very thorough course." P.L. (Dec. 2022)

"This course had concise information, it had links to respiratory health, predictors of aspiration, and aspiration risks. The education and key factors of establishing a good oral hygiene protocol for staff was beneficial. The time frame was perfect, great information, and all valuable." W.R. (Dec. 2022)

"Being provided with more information related to dehydration and the effects on overall health in the elderly was good. The speaker did a nice job presenting the information at a pace that was easy to follow." J.M. (Dec. 2022)

"I liked the discussion about the risk of aspiration with consumption of tap water and the anatomy of the lungs that allows for the rapid resorption of water. I liked how the video was broken up into smaller portions." S.M. (Dec. 2022)

"The research supporting the need for water protocol was helpful. Patient-focused research with emphasis on quality of life was included in this course." T.B. (Nov. 2022)

"The supporting evidence in this course is beneficial. Learning about reduced intake factors was new knowledge for me and I will be able to discuss with my patients and families. The educational information that I can take back to my patients and families is so valuable." A.S. (Nov. 2022)

"I learned how to identify patients who are appropriate for implementing free water protocol." A.P. (Nov. 2022)

"Learning importance of oral care and the accessibility of the course." V.C. (Nov. 2022)

"This course was interesting." A.M. (Oct. 2022)

"I liked learning how the FWP can be implemented." D.O. (Oct. 2022)

"Good review of the evidence." A.S. (Aug. 2022)

"It was nice to have handouts and recommendations with experience. I liked the research information and specific guidelines for the protocols." J.S. (Aug. 2022)

"Informative course. I liked the research citations." K.R. (July 2022)

"I liked learning about the history of the free water protocol. Course provided good data." C.B. (June 2022)

"I better understand now the research behind Frazier Water Protocol. Course had nice pace, comprehensive review of research with practical application." J.N. (May 2022)

"I liked the considerations for applying course content/research to the acute care setting. Comprehensive review of research available." J.B. (May 2022)

"Solid background info and research citations. I liked the information regarding dehydration." A.H. (Mar. 2022)

"I liked the information on dehydration. Very practical information for outpatient rehab." R.J. (Mar. 2022)

"I liked the research presented on water protocols and the actual protocol section as well as history of development." A.J. (Mar. 2022)

"Research based with contraindications for FWP. Super thorough, lots of research included." M.K. (Mar. 2022)

"I liked the functional information for justifying water protocols in the hospital setting." J.B. (Feb. 2022)

"I liked the review of evidence-based tips for implementation of a FWP." F.S. (Jan. 2022)

"Easy to understand and follow, the slides matched the presentation. I liked the team approach to the protocol." J.L. (Jan. 2022)

"Details about the protocols relates directly to my daily work. Practical implementation of water protocols." S.B. (Jan. 2022)

Course Objectives

At course conclusion, participants will be able to:

  1. Describe the likelihood of adherence to safe swallowing and other health care recommendations with realistic human behavior.

  2. Identify aspiration pneumonia and dehydration risk factors.

  3. Summarize the risks and benefits of choosing to recommend thick liquids as a dysphagia intervention.

  4. Apply informed decisions to determine patient candidacy for a water protocol.

  5. Summarize the essential guidelines of a water protocol.

Presenter & Disclosures

Kathy Panther, MS, CCC-SLP, CBIST

Kathy Panther, MS, CCC-SLP, CBIST, spent her career at Frazier Rehab Institute in Louisville, Kentucky. Kathy was a member of the team at Frazier that hatched the earliest of the free water protocols, the Frazier Water Protocol (FWP). Kathy and team, over more than three decades, managed thousands of patients with dysphagia on the FWP. Beyond her clinical work, Kathy became a leader at Frazier Rehab serving as the Inpatient Rehab Director and the Director of the Brain Injury Program. Kathy played a unique role in formally facilitating culture shaping training with colleagues in her organization while navigating health care mergers and every-present operational changes. Kathy greatly enjoyed educating health care professionals on acquired brain injury, oral care practice, hydration management, and implementing free water protocols.

Speaker Disclosures:

Financial — Kathy Panther is presenter of online CE courses sponsored by Northern Speech Services; receives royalties.

Nonfinancial — Kathy Panther has no relevant nonfinancial relationships to disclose.

Intended Audience / Accreditation

Intended Audience/Accreditation
asha ce approved provider

This program is offered for 0.3 ASHA CEUs (Intermediate Level; Professional Area).

Intended Audience

  • Speech-Language Pathologists

ASHA CEUs: NSS online courses are registered with ASHA and are offered for ASHA CEUs. The number of ASHA CEUs is noted above. Note that 0.1 ASHA CEU = 1 contact hour = equals 1 CEE.

ASHA CE Registry: During the enrollment process, if you select to receive ASHA credit for this course and if you provide your ASHA number, NSS will automatically submit your CEU information to the ASHA CE Registry after successful course completion (80% on post test). This submission happens once per month, during the first week of the month. For example, if you complete your course on November 7th, NSS will submit all November online course CEUs to ASHA during the first week of December. When ASHA inputs the information into their database, they will mark the course as completed on the last day of the month in which it was completed, so November 30th using this example. The certificate of completion available for you to print immediately, however, will reflect the actual completion date, November 7th in this example. Due to ASHA processing procedures please allow 2-3 weeks, from the submission date, for the course to appear on your ASHA transcript.

ASHA CEUs: Attendees must meet at least one of the following conditions in order to be eligible to earn ASHA CEUs:

  • Current ASHA Member
  • ASHA Certificate of Clinical Competence (CCC) Holder
  • Licensed by a state or provincial regulatory agency to practice speech-language pathology (SLP) or audiology
  • Credentialed by a state regulatory agency to practice SLP or audiology
  • Credentialed by a national regulatory agency to practice SLP or audiology
  • Engaged in a Clinical Fellowship under the supervision of an individual with their ASHA CCC
  • Currently enrolled in a master's or doctoral program in SLP or audiology

If an attendee is not an ASHA member or CCC holder but meets any of the above criteria, they may inform the ASHA CE Registry of their eligibility by visiting this site.

Licensing Boards: Most state licensing boards DO accept CEUs earned online (usually classified as home-study credits). Some state boards do, however, place a limit to the number of credits that can be earned via home study/online courses. For the most current information, we suggest that you contact your licensing board or agency to verify acceptance policies and/or any credit limits related to home-study courses prior to registering for this course.

Additional accrediting agencies by which Northern Speech is an approved CE provider:

  • California: NSS is approved as a provider of continuing education by the California Speech-Language Pathology & Audiology Board. Provider #PDP4. Online CEU limits may apply; please contact SLPAHADB for current online CEU acceptance policies.
  • Iowa: NSS is approved as a provider of continuing education by the Iowa Board of Speech Pathology and Audiology Examiners. Provider #169.
  • Kansas: NSS is approved as a provider of continuing education by the Kansas Department of Health and Environment. Provider #LTS-S0005.

Frequently Asked Questions

Online Course FAQ — Click Here

Customer Support: Please phone 888.337.3866 or email info@northernspeech.com.

Course Completion Timeframe:

You have unlimited time to complete our online courses. You may log off and log on as often as you’d like to in order to complete all sections of a course.

However, completion dates are based on Eastern Standard Time. Therefore, if you need your CEUs by a certain date, be sure to complete the course test before 11:59pm EST on that date. For example, if you need CEUs before January 1st, you will need to complete the course test before 11:59pm EST on December 31st.

Content Access:

Access to course materials and content does not expire, even after completing the post test. You may continue to review course material by logging into your NSS account, clicking the My Online Courses tab, and then viewing your desired course.

Certificate of Completion:

On successful completion of the post test (80%), a certificate will be immediately available for download and/or printing. This certificate will include your name, date of completion (based on Eastern Time Zone, USA/Canada), and number of contact hours (CEUs / CEEs). Please note that CEUs are awarded on the date of successful test completion, not the date of course enrollment. Please ensure that you successfully complete the post test prior to any licensure renewal dates.

ASHA CE Registry Submission:

During the enrollment process, if you select to receive ASHA credit for this course and if you provide your ASHA number, NSS will automatically submit your CEU information to the ASHA CE Registry after successful course completion (80% on post test). This submission happens once per month, during the first week of the month. For example, if you complete your course on November 7th, NSS will submit all November online course CEUs to ASHA during the first week of December. When ASHA inputs the information into their database, they will mark the course as completed on the last day of the month in which it was completed, so November 30th using this example. The certificate of completion available for you to print immediately, however, will reflect the actual completion date, November 7th in this example. Due to ASHA processing procedures please allow 2-3 weeks, from the submission date, for the course to appear on your ASHA transcript.

Purchase Orders:

Purchase orders are currently not accepted for online orders, if you wish to submit a purchase order please do so at info@northernspeech.com or fax to 888-696-9655.

What is an Online Course?

Our Online Courses consist of video, audio, and/or text content and are offered for ASHA CEUs. Unlike a webinar, which requires participants to be logged on and at a computer at specific times, our Online Courses are available to you at any time, from any device, via your NorthernSpeech.com online account. You may work at your own pace and start and stop your course as you wish. Your course will conclude with a short post test. On successful completion of the post test (>80%), a printable certificate of completion is presented to you.

Receiving CEUs:

Northern Speech is an ASHA CE Provider and our online courses are registered with ASHA and offered for ASHA CEUs. Please note that successful completion of the online post test is required prior to the awarding of CEUs. Please contact your state licensing board for acceptance policies related to CEUs earned online. Please note that courses offered for university students are not applicable for CEUs.

Registering for an online course:

You may browse all online courses by clicking the Continuing Education tab above, then Online Courses. Once you find a course, click Enroll Now, and you will be asked to either log into your existing Northern Speech account or create a new online account. Once you’ve entered your account information and provided your credit card payment, your course will be immediately available to you.

Accessing your purchased course or returning to a purchased course:

You will be able to access your online course by logging into your Northern Speech account and then clicking the My Online Courses tab on your profile screen. Click the course you would like to start or to resume. From there, proceed through the course sections until you are ready to complete the post test. You do not have to complete your course all at once. You may log on and off as you wish.

Testing requirements:

Each online course concludes with a post test consisting of multiple choice or true & false questions. Scores of 80% or greater are required for successful course completion and awarding of CEUs. You may revisit course materials and retest as needed to achieve a passing score.

Number of CEUs offered:

We offer courses from 1 to 21 contact hours. Each course will note the number of CEUs offered. Please note that 0.1 CEU = 1 contact hour = 1 CEE.

State licensing boards and online CEUs:

NSS is an ASHA CE Provider and most state licensing boards DO accept ASHA CEUs earned online (usually classified as home-study credits). Some boards do, however, place a limit to the number of CEUs that can be earned via home study/online courses. For the most current information, we suggest that you contact your licensing board or agency to verify acceptance policies and/or any CEU limits related to home-study courses prior to enrolling in an online course.

Course formats:

Our course formats include: text, audio, video, and PowerPoint with author narration. Each course will note the format on the course description page. Most courses include closed captioning.

Course handouts:

Most of our online courses provide a link to download the accompanying handout as a PDF file. 

Group discounts:

Groups of 3 or more are eligible for a 20% discount on each registration on most of our online courses. To receive this discount, registrations need to be processed together via the "Group Rates" tab on the Online Course of your choice.

Computer requirements:

For our online courses to function best, we recommend that you update your computer to include the newest version of your Internet browser (Safari, Chrome, Firefox, Edge, Internet Explorer, etc.) and newest version of your computer's operating system. Also a high-speed Internet connection is recommended (cable or DSL). Speakers or headphones will be required for many of our courses as many contain audio components.

Course Cancellation Policy:

A purchased online course can be exchanged, refunded, or transferred to another individual if contact is made with NSS (via phone or email) within 30 days of purchase and the course materials have not been viewed or downloaded. 

Special Needs:

Please click here for any special needs requests, and we will do our best to accommodate them. 

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