Swallowing screening practice patterns for nurses in the cardiac surgery intensive care unit

Area of Science:

• Nursing Practice
• Critical Care Medicine
• Swallowing Disorders

Background:

• Swallowing impairment (dysphagia) is a common and serious complication after cardiac surgery.
• Early detection of dysphagia is crucial for timely intervention and improved patient outcomes.
• Currently, there is a lack of validated guidelines for nursing-led dysphagia screening in cardiac ICUs.

Purpose of the Study:

• To survey nurse practice patterns for swallowing screens in an academic cardiac ICU.
• To assess nurses' training, confidence, methods, timing, and frequency of dysphagia screening.
• To identify subsequent care plans for high-risk patients identified with dysphagia.

Main Methods:

• An anonymous, voluntary 10-item mixed-methods online survey was administered to nurses in a cardiac ICU.
• Nonprobability purposive sampling was used for recruitment.
• Thematic analysis and descriptive statistics were employed for data analysis.

Main Results:

• 84% of nurses responded to the survey (n=69).
• Only 18.6% of nurses reported formal training in swallowing screens.
• Nurses reported moderate (49%) to low (13%) confidence in performing screens, utilized 15 different methods, and identified 31 dysphagia signs.

Conclusions:

• Cardiac ICU nurses have limited formal training and significant variability in dysphagia screening methods and sign identification.
• There is a clear knowledge gap and a need for standardized education and validated screening tools for nursing staff.
• Implementing formal education and validated tools can improve the early detection and management of dysphagia in cardiac surgery patients.