[Risk for dysphagia screening tools - a review of the international literature]

Elderly people have an increased risk to suffer from dysphagia due to age-related physiological alterations and neurological disorders. The consequences of untreated dysphagia are malnutrition and dehydration and the aspiration of solid and liquid food into the respiratory tract, which can lead to life-threatening pneumonia. On this background the care of the elderly people in nursing homes is a challenge for nurses. The aim of this literature review is to identify suitable screening tools and to evaluate their practicability for nurses' everyday work. The database search was conducted in CINAHL, Ovid Medline and EMBASE. Ten screening tools fitted the selection criteria. Most of them are developed by speech and language therapists and physicians, only two tools are designed by nursing scientists. A swallowing test is part of all screening tools; the target population are stroke patients in their acute phase. Other relevant criteria besides the swallowing test are, e. g. the patients' health status, taking of psychotropic drugs, and posture. All instruments are described as simple to use. They are tested for validity, and sometimes for reliability, but the tools are mostly not appropriate for the use in institutional geriatric care settings. The two instruments developed by nurse scientists are only of limited use in nursing homes, because both instruments were not tested in nursing homes and only one of these tools shows acceptable values of interrater reliability and criterion-related validity. As a result, a screening tool for the target group and a training programme for nurses should be developed.