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IDDSI flow testing inservice: So easy and fun!

Posted by Mandi Wilhelm, MA CCC-SLP on

Anyone else trying to get the ball rolling on IDDSI in a SNF setting? I thought I'd share my experience of an inservice I did recently to introduce IDDSI and train staff members on flow testing. By the way, there are some excellent videos by IDDSI, which can be found on Youtube, if you're just starting to research IDDSI. I would highly recommend looking at all of the official IDDSI information, and watching their presentation on flow testing prior to trying to teach it to others. 

Here are the things you'll need: 

  • 10 mL syringes (be sure to get the correct syringes, as specified on the IDDSI website)
  • Cups (to be used under syringes during group flow testing to catch the liquid)
  • Stopwatch (we used the stopwatch/timer feature on the iPhone)
  • A variety of liquids available in your facility (we tested both warm and cold temperatures for all supplements)
  • A recording sheet (I'll attach the one I made here)
  • Donuts***Disclaimer:This is not a part of flow testing. It was strictly for consumption of attendees and obviously optional, but it's always nice to sweeten the deal, right?!***

Here's what I did:

First, I made this a really hands-on experience for everyone. No powerpoint and no lecture; I wanted everyone to be engaged in learning. I explained the reason for meeting: to get familiar with IDDSI and a specific type of testing, called flow testing, for identifying liquid levels. Then I gave a little background information on our current diet levels, why IDDSI was created, how we'll start seeing this (because I work in a SNF, we will most likely start seeing this in documentation from hospitals on incoming admissions or in reports from instrumental testing providers), and why we need to start to make the switch. 

I used IDDSI handouts to describe the liquid levels and to give an overview of flow testing procedures. They really have some great visuals on the IDDSI website. There is no need to recreate the wheel for handouts. I demonstrated flow testing once, step by step. We quickly got to the fun part! I gave out cups and syringes to attendees and asked them to help me check flow rates for various liquids. You could divide into teams if you have a large group, we were small enough to just work as a single group. We recorded multiple trials per liquid (most were dietary supplements), and then decided which level each liquid fit into, together. This opened up some great discussion on WHEN someone might need to flow test, and where the syringes could be kept for easy access by nursing staff. 

So, if you're writing out your own bullet points for an inservice, here are the points I'd suggest hitting (as described above):

  • Why are we meeting?
  • What is IDDSI?
  • Why do we need to know IDDSI?
  • What is the terminology/ what are the levels?
  • How do we flow test?

Afterward, I compiled all of our data from the flow testing into a color-coded chart for reference, like this: 

We were careful to trial liquids at a variety of temperatures for our own information. It was seriously one of the most engaging and interesting inservices I've ever done. If you are hesitant to get started, don't be! There's very little preparation required, except for getting familiar with the process yourself. I'll attach my recording sheet here for your use, if you need it.

I hope you all enjoy the process as much as I did.

Here are some links to IDDSI materials that I found most helpful:

Happy flow testing!


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