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

Area of Science:

• Neurology
• Public Health
• Nursing Science

Background:

• Stroke incidence is rising in low- and middle-income countries.
• Stroke unit care, including swallowing and hydration protocols, reduces disability and mortality.
• Effective management of swallowing and hydration is critical for acute stroke patients.

Purpose of the Study:

• To codesign a swallowing and hydration care bundle for nurses caring for acute stroke patients.
• To implement and evaluate this care bundle across three acute stroke units in India.

Main Methods:

• A multicentre, pre- and postimplementation feasibility study.
• Co-design of a care bundle incorporating the 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, with 23% found dehydrated.

Conclusions:

• The care bundle implementation was feasible in Indian stroke units.
• The intervention significantly improved swallowing and hydration management.
• This study demonstrates a successful model for enhancing stroke patient care.