Clinical assessment and screening of stroke patients with aphasia: a best practice implementation project

Abstract

Introduction and aims: As a critical form of stroke damage, aphasia negatively impacts stroke patients' return to society. Speech and language intervention has been found to assist in optimizing poststroke aphasia patient outcomes; consequently, early identification and diagnosis are vital for poststroke aphasia to ensure that patients receive the rehabilitation they require. This project aimed to promote evidence-based practice (EBP) in the assessment and screening of stroke patients with aphasia and to improve the clinical outcomes of patients who suffer from poststroke aphasia in a large tertiary hospital. Methods:The current evidence implementation project was conducted in the neurology and rehabilitation departments of a tertiary hospital in China. Six audit criteria were developed for the baseline and follow-up audits. The project used the JBI PACES software, as well as JBI's Getting Research into Practice audit and feedback tool, to foster evidence-based healthcare in practice.Results: Although the performance of all evidence-based criteria during the baseline audit was poor, barriers were identified through baseline, and the project team carried out and implemented developed strategies following Getting Research into Practice resources. All the criteria improved from baseline after the follow-up cycle, with four out of six criteria achieving a compliance rate of 100%, and two evidence-based criteria recorded at 73 and 80% compliance, respectively. Conclusion:The current project successfully increased EBP for the assessment and screening of stroke patients with aphasia. Further studies are needed to ensure the project's long-term sustainability.

The self‐management experiences of individuals who perceive health as beyond their control: An interpretive phenomenological study of individuals with ischemic heart disease

“…The study was conducted at a university hospital in Guangzhou, Guangdong, PR, China, specifically in the geriatric department, which includes specialized cardiovascular wards. This department primarily admits patients with stable illnesses who reside in nearby communities or towns (Wang, Wei, et al, 2022). Participants were recruited based on specific inclusion criteria, including (1) individuals in a stable health condition diagnosed with IHD, which includes coronary heart disease, coronary artery disease, myocardial infarction, post‐coronary artery bypass grafting, and post‐percutaneous coronary intervention, (2) being able to communicate in Mandarin, (3) willingness and ability to provide detailed descriptions of their disease management experiences, and (4) meeting the inclusion criteria determined by the Multidimensional Health Locus of Control (MHLC) Scale (Wallston et al, 1978).…”

Nurse-led speech therapist referral initiative for older adult patients at risk of dysphagia: a best practice implementation project

“…Dysphagia in older adults occurs at a similar rate as stroke, yet the frequency of preventive measures such as swallow screening is low 4,5 . Even though the prevalence of dysphagia in patients aged 65 years or older can be as high as 50%, 6 most health facilities do not routinely screen patients 7 despite the well-documented merits of dysphagia screening 8 …”

“…Nurses spend most of their time providing bedside care to patients in busy wards. Nurses could administer routine screening using a workable measure to facilitate timely referral to the ST, preventing at-risk patients from choking during meals 5 . Hence, nurses could play an important role in the early detection of patients with signs or symptoms of dysphagia 13 .…”

“…3 Dysphagia in older adults occurs at a similar rate as stroke, yet the frequency of preventive measures such as swallow screening is low. 4,5 Even though the prevalence of dysphagia in patients aged 65 years or older can be as high as 50%, 6 most health facilities do not routinely screen patients 7 despite the well-documented merits of dysphagia screening. 8 Early identification of dysphagia in older patients in hospitals is warranted due to the resulting risk of malnutrition, readmission for pneumonia, and increased length of hospital stay and cost.…”

“…Nurses could administer routine screening using a workable measure to facilitate timely referral to the ST, preventing at-risk patients from choking during meals. 5 Hence, nurses could play an important role in the early detection of patients with signs or symptoms of dysphagia. 13 Therefore, a short swallow screening test such as the 4-point questionnaire test (4QT) 1 could be used.…”