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An inter-disciplinary approach to swallowing problems in acute stroke.
S Davies1, H Taylor, A MacDonald
1Queen Elizabeth Hospital, Sheriff Hill, Gateshead NE9 6SX. stephen.davies@connectfree.co.uk
Summary
Nurses can be trained to screen for dysphagia (swallowing difficulties), improving care for stroke patients. A coordinated dysphagia management policy (DMP) ensures timely and appropriate feeding precautions, reducing workload on speech and language therapy (SLT).
Area of Science:
- Medicine
- Clinical Practice
Background:
- Speech and Language Therapy (SLT) departments face overwhelming dysphagia referrals.
- Acute stroke patients frequently have undiagnosed or poorly managed swallowing problems.
Purpose of the Study:
- To assess the effectiveness of nurse-led dysphagia screening and management in acute stroke units.
- To improve the implementation of dysphagia management policies (DMP).
Main Methods:
- The Collaborative Dysphagia Audit (CODA) involved training nurses in basic dysphagia screening.
- Implementation of a co-ordinated inter-disciplinary dysphagia management policy (DMP).
- Development of higher-level nurse training to manage routine swallowing problems, reserving complex cases for SLT.
Main Results:
- Nurses can be rapidly trained to perform basic dysphagia screening assessments.
- Implementation of a DMP significantly increased appropriate feeding precautions for dysphagic patients.
- Higher-level nurse training enabled management of most transient swallowing issues, reducing SLT referrals.
Conclusions:
- Nurse-led screening and management protocols are effective for dysphagia in acute stroke.
- A coordinated DMP, supported by specialized roles like a dysphagia nurse specialist, optimizes patient care and resource allocation.
- This inter-disciplinary approach enhances early management of swallowing difficulties in stroke patients.