Four-hour swallow screening target for stroke - from guidelines to practice: A mixed methods knowledge translation...

Area of Science:

• Neurology
• Healthcare Management
• Clinical Practice

Background:

• Stroke patients require timely swallow screening to prevent aspiration pneumonia.
• Current stroke guidelines recommend screening within 4 hours of admission.
• Compliance with this critical timeframe remains a challenge in many healthcare settings.

Purpose of the Study:

• To systematically analyze compliance rates for swallow screening within a 4-hour target.
• To identify barriers and facilitators influencing adherence to the 4-hour swallow screening timeframe.
• To inform strategies for improving timely swallow screening in stroke care.

Main Methods:

• A mixed-methods approach combining quantitative and qualitative data analysis.
• Quantitative analysis of 12-months of medical records from a metropolitan hospital.
• Qualitative analysis of 14 semi-structured interviews using the Theoretical Domains Framework.

Main Results:

• 74% of eligible stroke patients received a swallow screen; 52% were within the 4-hour target.
• Facilitators included nurse training, belief in screening benefits, and specialist stroke nurse availability.
• Barriers to timely screening were overnight admissions and non-stroke unit care.

Conclusions:

• 52% compliance with the 4-hour swallow screening target highlights a gap in current stroke care.
• Identified barriers, such as admission timing and unit type, offer targets for quality improvement.
• Addressing these barriers can enhance compliance with international best practice guidelines for stroke management.