RN dysphagia screening, a stepwise approach

According to the Joint Commission, dysphagia, which occurs in anywhere from 27% to 50% of stroke patients and often leads to aspiration, is a significant quality/safety indicator. As such, it is identified as a standard of performance when awarding disease-specific certification in stroke care. Application for this certification required one institution to assign a multidisciplinary process improvement team to develop and implement a dysphagia screening protocol to replace their current practice, which was being used on an inconsistent basis. This article outlines the steps necessary to identify and tailor a tool for dysphagia screening, develop a protocol to ensure appropriate use of said tool, and use a multiphase implementation process to identify strengths and weaknesses as well as create caregiver support for the practice change.