Table 1.

Issues identified during the preparation phase for GFSWP implementation

Issue	Response
Eligibility	Exclusion criteria to determine those patients for whom a water protocol would be contraindicated
Oral health	(a) Procedures for evaluating and documenting oral health status in patients being considered for a water protocol (b) Procedures to determine whether suction equipment is needed during oral care activities for patients who will be on the water protocol
Medical approval	A physician’s order will be obtained for the water protocol for all selected patients, so that medical contraindications are considered and so that the provision of water is considered of equal importance to the administration of medications
Supervision/assistance	Team assessment to determine whether a patient is able to follow the rules and complete all the steps of the water protocol, including oral care, independently, or whether supervision/assistance is needed
Rules for water provision	Water will be delivered by a nurse in a new, labeled, graduated bottle each morning. Water will be poured from this bottle into a cup for drinking. New bottles of water will be stored at the nursing station. Water bottles will be replaced when empty, not refilled
Procedures for recording water intake	The water remaining in the previous bottle will be recorded on a water intake sheet, noting the bottle label number, upon delivery of a new bottle
Access	Patients who are determined to need assistance will be explicitly offered water by clinical staff throughout the day, between meals
Accountabilities	Policies to identify the roles, responsibilities, accountabilities, and documentation requirements of different members of the interdisciplinary health-care team in supporting implementation of the water protocol