A New Simple Screening Tool—4QT: Can It Identify Those with Swallowing Problems? A Pilot Study

Tsang, Karwai; Lau, Esther; Shazra, Mariyam; Eyres, Ruth; Hansjee, Dharinee; Smithard, David

doi:10.3390/geriatrics5010011

Cited by 18 publications

(28 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Alternatively, the Gugging Swallowing Screen (GUSS) typically used as a screening tool for acute stroke patients could be used, but it has limitations as well, according to the acute inpatient population [ 25 , 26 ]. Recently, a new tool consisting of four questions has been introduced, but it was not available when the present study was performed [ 27 ]. The V-VST could be an alternative as well, as it can be used as a screening or assessment tool depending the testers’ qualifications and the setting.…”

Section: Discussionmentioning

confidence: 99%

Systematic Dysphagia Screening of Elderly Persons in the Emergency Department—A Feasibility Study

et al. 2020

View full text Add to dashboard Cite

Identification of elderly patients in risk of dysphagia as early as possible upon hospital admission seems warranted due to the risk of aspiration pneumonia, dehydration, length of stay, and increased mortality. This study aimed to evaluate the feasibility and outcome of dysphagia screening of elderly persons admitted to the emergency department (ED). Inclusion criteria were age ≥ 60 years. A nurse applied the Simple Water Swallow test within one hour of admission. Subsequent assessment was performed by an occupational therapist (OT) using Volume Viscosity Swallow Test and Minimal Eating Observation Form. Of 113 eligible participants (median age 78 years), 75 (66%) were screened in the ED by the nurse, and among those, 12 (16%) were detected with dysphagia. Twenty of the patients not screened in the ED due to critical illness were tested by the OT in the ward after clinical stabilization and 15 patients (75%) were identified with dysphagia. This study demonstrated that it is feasible to perform dysphagia screening of elderly persons by a nurse in the ED, but there are severe limitations according to screening patients with critical illness and patients fasting before surgery in the ED. These patients have a high prevalence of dysphagia and should be screened as early as possible after hospitalization, as it will rarely be possible in the ED.

show abstract

Section: Discussionmentioning

confidence: 99%

Systematic Dysphagia Screening of Elderly Persons in the Emergency Department—A Feasibility Study

et al. 2020

View full text Add to dashboard Cite

show abstract

“…The purpose of screening for dysphagia is to screen whether or not it is safe for patients to eat, drink and take oral medications (4,7,10,23). According to the recommendations of the 2019 AHA, all stroke patients should be treated with dysphagia screening before eating, drinking, or receiving oral medication (25).…”

Section: Dysphagia Screeningmentioning

confidence: 99%

<strong></strong>Dysphagia Screening Protocol For Acute Stroke Patient: A Literature Review

Mulyatsih¹,

Pandin²

2021

Preprint

View full text Add to dashboard Cite

Background: Nearly two-thirds of acute stroke patients have dysphagia. Dysphagia defined as difficulty in swallowing of liquids or food, vary in severity with symptoms ranging from mild throat discomfort to inability to eat. It’s well known that dysphagia is associated with aspiration pneumonia, dehydration, malnutrition, prolonged length of stay, and increased mortality. Early screening reduces pneumonia rates in stroke and it is usually performed by nurses. Dysphagia screening is recommended but no protocol or tool is pointed.Aim: the aim of this study is to conduct a literature review of dysphagia screening for stroke patient Methods: Literature search three databases (Scopus, Proquest, and Science Direct), with the keywords "Dysphagia" AND "Stroke" AND "Nursing", published in English between 2019 and 2021. Result: Twenty five publications relating to dysphagia screening met the inclusion criteria. There are five methods of dysphagia screening performed by nurses or other health workers: 1) a simple Questionnaire Test (4QT) method, which is by asking the following four questions: does the patient cough or choke while eating or drinking; whether the patient takes longer than usual to eat; does the patient change the thickness of the food to be able to swallow, and whether the voice turns hoarse after eating or drinking; 2) Water Swallow Test (WST) method; 3) Bed Side Screening Tool for Dysphagia (BSTD) method; 4) Volume Viscosity Swallow Test (V-VST) method, namely modification of feeding with first pudding, nectar and finally water; 5) Simplified Cough Test Method. The five screening methods for dysphagia above have been tested for sensitivity and specificity, as well as positive and negative predictive valuesConclusion: screening is a first step in the identification of swallowing impairment or dysphagia of stroke patient. Dysphagia is an independent predictor of poor patient outcome and prolonged recovery time. Nurse has an important role to conduct a screening and must ensure that the selected tools has high reliability and concurrent validity. Key Words: Stroke, Dysphagia, Screening, Nursing

show abstract

“…TOR-BSST has been validated in older patients [18]. A rapid screening questionnaire [19,20] must have reasonable specificity and sensitivity to trigger a referral to the speech and language therapy (pathology) department. The management of dysphagia is complex and involves a multidisciplinary team ( Table 2).…”

Section: Swallowing Problemsmentioning

confidence: 99%

Optimising Medicines Administration for Patients with Dysphagia in Hospital: Medical or Nursing Responsibility?

2020

Self Cite

View full text Add to dashboard Cite

Dysphagia is common—not only associated with stroke, dementia, Parkinson’s but also in many non-neurological medical problems—and is increasingly prevalent in ageing patients, where malnutrition is common and pneumonia is frequently the main cause of death. To improve the care of people with dysphagia (PWD) and minimise risk of aspiration and choking, the textures of food and drinks are frequently modified. Whilst medicines are usually concurrently prescribed for PWD, their texture is frequently not considered and therefore any minimisation of risk with respect to food and drink may be being negated when such medicines are administered. Furthermore, evidence is starting to emerge that mixing thickeners with medicines can, in certain circumstances, significantly affect drug bioavailability and therefore amending the texture of a medicine may not be straightforward. Research across a number of hospital trusts demonstrated that PWD are three times more likely to experience medication administration errors than those without dysphagia located on the same ward. Errors more commonly seen in PWD were missed doses, wrong formulation and wrong preparation through medicines alteration. Researchers also found that the same patient with dysphagia would be given their medicines in entirely different ways depending on the person administering the medicine. The alteration of medicines prior to administration has potential for patient harm, particularly if the medicine has been designed to release medicines at a pre-defined rate or within a pre-defined location. Alteration of medicines can have significant legal implications and these are frequently overlooked. Dispersing, crushing or mixing medicines can be part of, or misconstrued as, covert administration, thus introducing a further raft of legislation. Guidance within the UK recommends that following identification of dysphagia, the ongoing need for the medicine should be considered, as should the most appropriate route and formulation, with medicines alteration used as a last resort. The patient should be at the centre of any decision making. Evidence suggests that in the UK this guidance is not being followed. This article considers the clinical and legal issues surrounding administration of medicines to PWD from a UK perspective and debates whether medicines optimisation should be the primary responsibility of the prescriber when initiating therapy on the ward or the nurse who administers the medicine.

show abstract

A New Simple Screening Tool—4QT: Can It Identify Those with Swallowing Problems? A Pilot Study

Cited by 18 publications

References 28 publications

Systematic Dysphagia Screening of Elderly Persons in the Emergency Department—A Feasibility Study

Systematic Dysphagia Screening of Elderly Persons in the Emergency Department—A Feasibility Study

<strong></strong>Dysphagia Screening Protocol For Acute Stroke Patient: A Literature Review

Optimising Medicines Administration for Patients with Dysphagia in Hospital: Medical or Nursing Responsibility?

Contact Info

Product

Resources

About