Development of a Robust, Valid and Reliable Swallow Screening Tool for Nurses to use with Stroke Patients

Swallowing difficulties (dysphagia) occur in 45% of acute stroke patients (DePippo 1994), causing aspiration pneumonia and malnutrition, significantly impairing rehabilitation. The intercollegiate working party for stroke guidelines 2004 state that the patient should have their ‘swallow assessed as soon as possible by a suitably trained specialist who should then advise the patient and staff on safe swallowing and consistency of diet and fluid’.

Speech and language therapists (SALTs) are recognised as having the pre-requisite training and skills to assess and manage dysphagic individuals.

Despite nurses being recognised as having an important role in identifying patients at risk (RCSLT 1998, RCP 2000), there is diversity in role definition, where some will be solely screening patients and others will screen, assess and directly manage simple cases.

Method

Settings Royal Liverpool and Broadgreen University Hospitals NHS Trust

Plan of Investigation

• What drinks, food and consistencies are used in a swallow screening tool as part of current practise? A review of current clinical practise will be implemented, the results considered and where appropriate incorporated into the study.
• A postal questionnaire will be disseminated in order to survey all Speech and Language Therapists (90) and nurses (200) from the North West Stroke Task Force Database, to establish which textures/fluids are currently recommended for use in swallow screening. Telephone interviews will be used to follow up non-respondents and to clarify any misinterpretation of questions.