Reaching the target for stroke swallow screening & assessment

Jana Havlis1, Nicolette Varvounis1, Dr Joanne Murray2

1Northern Adelaide Local Health Network, , Australia, 2Flinders University, South Australia

The Australian Clinical Guidelines for Stroke Management (2017) recommend that people with acute stroke have their swallowing screened within four hours of arrival at hospital and before being given any oral food, fluid or medication. Lyell McEwin Hospital (LMH) is largely meeting the target for a swallow screen or assessment within 24 hours but compliance with the nurse-led screening process and the 4 hour timeframe is variable. LMH Speech Pathology completed an evaluation of swallowing screening (October 2017-September 2018) where 195/329 (59%) stroke admissions had a swallow screen conducted. 129/195 (66%) patients passed the swallow screen and commenced oral intake in a timely manner, which supports optimal patient nutrition/hydration and commencement of oral medications compared with historical practise to remain ‘nil by mouth’ for Speech Pathology assessment. With staff engagement/education, there was improved compliance overtime. In September 2018:

  • 88% of patients had a swallow screen conducted
  • 67% of patients had a swallow screen conducted or Speech Pathology assessment within four hours of admission
  • 91% of patients had a swallow screen conducted or Speech Pathology assessment within twenty-four hours of admission

There are hypothesized reasons and barriers to increased compliance but these are anecdotal and have not been systematically collected or analysed. By analysing the quantitative compliance data more systematically and then collecting and analysing barriers to compliance, clinicians will be more informed about potential solutions and better able to recommend change.  Once complete, the research project will have explored:

  • Analysis of compliance with swallow screening for stroke patients at LMH
  • Analysis of compliance with swallow screening and assessment within SA Health timing targets (4 hours and 24 hours respectively) for stroke patients at LMH
  • Barriers to compliance with swallow screening and the set timing targets
  • Potential solutions for implementation that will improve compliance

Biography: To be confirmed

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