The Codesign, Development and Implementation of an Indian Poststroke Swallow and Hydration Care Bundle: A Feasibility...

Area of Science:

• Neurology
• Public Health
• Nursing Practice

Background:

• Stroke incidence is rising in low- and middle-income countries.
• Stroke unit care, including swallowing and hydration protocols, reduces disability and mortality.
• Effective stroke management requires evidence-based interventions.

Purpose of the Study:

• To codesign a swallowing and hydration care bundle for nurses managing acute stroke patients.
• To implement and evaluate this care bundle across three acute stroke units in India.
• To enhance patient outcomes through improved swallowing and hydration support.

Main Methods:

• A multicentre, pre- and postimplementation feasibility study.
• Co-design of a care bundle including Global Evaluation of Swallowing and hydration screening.
• Implementation via clinical champions, education, and site support.

Main Results:

• 53 healthcare staff completed training.
• 183 patients were recruited.
• Swallowing evaluations increased from 23.9% to 56%.
• Calculated osmolarity (cOsm) monitoring increased from 0% to 73% of participants.
• 15% of participants were dehydrated.

Conclusions:

• Care bundle implementation was feasible in Indian stroke units.
• The bundle significantly improved swallowing and hydration management.
• This intervention holds potential for reducing stroke-related complications.