Dysphagia Screening Measures for Use in Nursing Homes: A Systematic Review

Park, Yeon Hwan; Bang, Hwal Lan; Han, Hae Ra; Chang, Hee Kyung

doi:10.4040/jkan.2015.45.1.1

Cited by 43 publications

(21 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A more formal approach may be used such as the bed side swallow assessments e.g., (TOR-BSST or GUSS [16,17] routinely used in stroke care. 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.…”

Section: Swallowing Problemsmentioning

confidence: 99%

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

2020

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

Section: Swallowing Problemsmentioning

confidence: 99%

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

2020

View full text Add to dashboard Cite

show abstract

“…Un reciente estudio de la Universidad de Seúl revisó 31 métodos de cribado (1992-2011) para elegir el óptimo basándose en: la calidad de la metodología de los estudios, propiedades de la medición de las herramientas utilizadas para la detección de disfagia y la aplicabilidad por enfermería. Concluyeron que los test GUSS (gugging swallowing screen) y SSA (standardized bedside swallowing assessment) son los que ofrecen mayor rigor científico y resultan aplicables en la práctica clínica diaria, sobre todo por enfermería (21).…”

Section: Evaluación De La Disfagia En El Paciente Con Ictusunclassified

¿Y después del ictus, qué hacemos para nutrirle?

Pomar¹

2017

Nutr Hosp

View full text Add to dashboard Cite

Neurological conditions usually cause altered levels of consciousness or swallowing mechanisms which make artifi cial nutritional support necessary. International guidelines recommend nutritional screening to detect malnutrition in patients with neurological diseases. Dysphagia is a common problem after a stroke, however, it is a treatable pathology, and swallowing rehabilitation allows for improving patients' nutritional status. Awareness of this problem is required among healthcare professionals both for its diagnosis and for the implementation of nutritional intervention measures. Patients should be tested for dysphagia within the fi rst 24 hours of the stroke onset; this swallowing assessment as well as malnutrition screening should never be delayed by more than 72 hours. The present study addresses diagnostic and therapeutic approaches, the indications of the different nutritional treatments available and the transition to oral feeding in patients who have had a stroke episode. ¿Y después del ictus, qué hacemos para nutrirle?How is the patient's nutrition after a stroke? ResumenLas enfermedades neurológicas conllevan, a menudo, alteraciones en el nivel de conciencia o en los mecanismos de la deglución que hacen necesario un soporte nutricional artifi cial. Las guías internacionales recomiendan realizar un cribado de malnutrición a los pacientes con enfermedades neurológicas. La disfagia es un problema frecuente después de un ictus. Sin embargo, la disfagia es una patología tratable y la rehabilitación de la función deglutoria permite mejorar el estado nutricional de los pacientes. Los equipos sanitarios deber estar sensibilizados ante este problema, tanto para su diagnóstico, como para instaurar medidas de intervención nutricional. La presencia de disfagia debería valorarse en las primeras 24 horas tras un ictus y no retrasarse más de 72 horas, así como el cribado de desnutrición. Se revisan el enfoque diagnóstico y terapéutico así como las indicaciones de las distintas modalidades de tratamiento nutricional y la transición a la alimentación oral en el paciente con ictus.

show abstract

“…In a study comparing SSA with summative clinical judgement of swallowing function, sensitivity was 0.97 and specificity 0.90, with positive and negative predictive values of 0.92 and 0.96 [9]. The protocol is considered the best non-instrumental screening tool for dysphagia after stroke in two systematic reviews [10, 11]. However, the methodological quality was questioned in another systematic review that suggested a possible risk of bias, partially due to the fact that summative clinical judgement was used as a reference test [12].…”

Section: Introductionmentioning

confidence: 99%

Repetitive Saliva Swallowing Test: Norms, Clinical Relevance and the Impact of Saliva Secretion

2018

View full text Add to dashboard Cite

Screening tests can be performed to identify stroke patients who require further assessment of swallowing function. The Repetitive Saliva Swallowing Test (RSST) is a screening test during which the patient is asked to swallow saliva as many times as possible for 30 s, while deglutition is counted through palpation of the larynx. This study aimed to establish normative values for three age groups of non-patients (total N = 120) on RSST. One patient group (N = 40) was also recruited from a geriatric stroke unit to assess whether RSST scores predicted outcomes on the Standardised Swallowing Assessment-Svenska (SSA-S), a clinical screening tool here used as a reference test. Since the RSST involves the swallowing of saliva, this study also measured the participants' saliva secretion in order to examine its effect on RSST performance. This study showed that RSST results vary with age (lower among older) and gender (higher for men than women), while the number of doctor-prescribed medications, objective saliva secretion and self-assessed dryness of mouth did not affect the performance significantly. In comparison to a more extensive clinical screening procedure (SSA-S), the RSST correctly predicted 93% of negative cases and 69% of positive cases. This suggests that patients who show signs of aspiration according to SSA-S have a lower probability of detection with RSST.

show abstract

Dysphagia Screening Measures for Use in Nursing Homes: A Systematic Review

Cited by 43 publications

References 25 publications

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

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

¿Y después del ictus, qué hacemos para nutrirle?

Repetitive Saliva Swallowing Test: Norms, Clinical Relevance and the Impact of Saliva Secretion

Contact Info

Product

Resources

About