Developing and Testing the Diagnostic Accuracy of a Brief Nursing Dysphagia Screen

Area of Science:

• Nursing
• Clinical Assessment
• Swallowing Disorders

Background:

• Pneumonia patients are at increased risk for dysphagia.
• Early identification of dysphagia is crucial for patient outcomes.
• Existing screening tools may not be optimized for nurse-initiated use.

Purpose of the Study:

• To develop and validate the Groppo-Lawless nurse-initiated screen.
• To identify patients with pneumonia at risk for dysphagia.
• To improve the accuracy of dysphagia screening in pneumonia patients.

Main Methods:

• A two-phase methodological study was conducted.
• Phase 1: Identified dysphagia risk factors, reviewed patient charts (N=301), and analyzed data from patients failing a 3-oz water trial (n=56) to construct the five-item screen.
• Phase 2: Compared nurse-administered screen results with blinded speech-language pathologist assessments.

Main Results:

• The Groppo-Lawless Dysphagia Screen demonstrated strong psychometric properties.
• Sensitivity was 81.1%, specificity was 96.4%, and the diagnostic odds ratio was 22.43.
• The screen effectively identified patients at risk for dysphagia.

Conclusions:

• The Groppo-Lawless Dysphagia Screen is a reliable tool for nurses.
• Its use can enhance appropriate referrals to speech-language pathologists for pneumonia patients.
• This can lead to timely interventions and improved patient care.