Evaluation of a service development to implement the top three process indicators for quality stroke care

Power, Maxine; Cross, Stephen P.; Roberts, Sarah; Tyrrell, Pippa J.

doi:10.1111/j.1365-2753.2006.00665.x

Cited by 4 publications

(1 citation statement)

References 9 publications

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“…When a swallowing screening protocol is implemented, there is a decrease in morbidity over each year that the protocol is in place [4]. Moreover, when hospitals implement a formal swallowing screening protocol for patients with stroke, there is improvement in clinicians' adherence with screening swallowing prior to oral intake [2], and the first dose of aspirin is administered earlier [5]. …”

Section: Introductionmentioning

confidence: 99%

Implementation of Stroke Dysphagia Screening in the Emergency Department

Daniels

Anderson

Petersen

2013

Nursing Research and Practice

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Early detection of dysphagia is critical in stroke as it improves health care outcomes. Administering a swallowing screening tool (SST) in the emergency department (ED) appears most logical as it is the first point of patient contact. However, feasibility of an ED nurse-administered SST, particularly one involving trial water swallow administration, is unknown. The aims of this pilot study were to (1) implement an SST with a water swallow component in the ED and track nurses' adherence, (2) identify barriers and facilitators to administering the SST through interviews, and (3) develop and implement a process improvement plan to address barriers. Two hundred seventy-eight individuals with stroke symptoms were screened from October 2009 to June 2010. The percentage of patients screened increased from 22.6 in October 2009 to a high of 80.8 in March 2010, followed by a decrease to 61.9% in June (Cochran-Armitage test z = −5.1042, P < 0.0001). The odds of being screened were 4.0 times higher after implementation compared to two months before implementation. Results suggest that it is feasible for ED nurses to administer an SST with a water swallow component. Findings should facilitate improved quality of care for patients with suspected stroke and improve multidisciplinary collaboration in swallowing screening.

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Section: Introductionmentioning

confidence: 99%

Implementation of Stroke Dysphagia Screening in the Emergency Department

Daniels

Anderson

Petersen

2013

Nursing Research and Practice

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Rehabilitation

O'Connor¹

2009

Foundation Studies for Caring

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Measuring the Quality of Dysphagia Management Practices following Stroke: A Systematic Review

Wall

Bernhardt

Edwards

et al. 2010

International Journal of Stroke

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Title and abstract review found 150 potential studies. Full-text review resulted in 25 publications that met the study's inclusion criteria. Thirteen process indicators were identified in the literature that related to the initial assessment, clinical management, rehabilitation and discharge planning for patients with acute stroke-related dysphagia. These processes were supported by levels of evidence ranging from high 'level 1' (8%) down to 'expert opinion' evidence (46%). Two process indicators did not align to recommendations in the clinical guidelines. This systematic review underpins informed selection of process indicators for evaluating the quality of dysphagia management following stroke. The selection of quality indicators is complicated by equivocal supporting evidence; however, indicators should reflect expected local practices, align with national stroke guidelines and be feasible for clinical auditing.

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Evaluation of a service development to implement the top three process indicators for quality stroke care

Cited by 4 publications

References 9 publications

Implementation of Stroke Dysphagia Screening in the Emergency Department

Implementation of Stroke Dysphagia Screening in the Emergency Department

Rehabilitation

Measuring the Quality of Dysphagia Management Practices following Stroke: A Systematic Review

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