Feasibility and acceptability of a dysphagia screening intervention for hospitalised older patients - a process...

To assess: (1) reach (patients screened for dysphagia), (2) dose (patients receiving 4 Questionnaire Test (4QT), 30 ml water swallow test, and if positive, dysphagia specialist referral), (3) acceptability of the dysphagia screening intervention among stakeholders, and (4) adaptations made or planned.

A process evaluation using a mixed methods approach was conducted at an orthopaedic surgery department in Denmark. Patients aged ≥65 years admitted with hip fracture were dysphagia screened. Data from electronic health records, semi-structured interviews with health professionals, management, and patients, and a logbook were analysed.

The screening procedure was performed by a multidisciplinary group of health professionals in 141 patients, achieving 94% reach and 92% completion of the 4QT and 30 ml water swallow tests, and near the success criterion for dysphagia specialist referrals (89%). The screening intervention was accepted by the participants, with positive feedback and no serious unexpected consequences. Three adaptations were made immediately, and four were planned.

The dysphagia screening intervention is feasible and acceptable, providing a strong basis for further research on diagnostic performance and broader clinical implementation. Enabling early identification and management of dysphagia may reduce disability, support effective rehabilitation, and improve outcomes.