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Accuracy of a Bedside Dysphagia Screening: A Comparison of Registered Nurses and Speech Therapists

Authors

  • Janice Weinhardt MSN BC APRN,

    Stroke Coordinator, Corresponding author
      weinharj@summa-health.org.
    Search for more papers by this author
    • Janice Weinhardt, MSN GCNS-BC, is stroke coordinator at Summa Health System Hospital in Akron, OH.

  • Susan Hazelett MS RN,

    Research AssociateSearch for more papers by this author
    • Susan Hazelett, MS RN, is a research associate at Summa Health Systems Hospital in Akron, OH.

  • Dawn Barrett MS CCC/SLP,

    Senior Speech PathologistSearch for more papers by this author
    • Dawn Barrett, MS CCC/SLP, is a senior speech pathologist at Summa Health Systems Hospital in Akron, OH.

  • Robert Lada MD,

    Director of Cerebrovascular MedicineSearch for more papers by this author
    • Robert Lada, MD, is is director of cerebrovascular medicine at Summa Health Systems Hospital in Akron, OH.

  • Trish Enos BSN BS RNC CPHQ,

    Manager of Performance Improvement and InformaticsSearch for more papers by this author
    • Trish Enos, BSN BS RNC CPHQ, is manager of performance improvement and informatics at Summa Health Systems Hospital in Akron, OH.

  • Rick Keleman RN

    ManagerSearch for more papers by this author
    • Rick Keleman, RN, is stroke unit manager at Summa Health Systems Hospital in Akron, OH.


weinharj@summa-health.org.

Abstract

Evidence-based guidelines suggest that stroke patients should be screened for dysphagia before oral intake. The purpose of this study was to validate a dysphagia screening tool comparing registered nurses (RNs) with speech therapists (STs). All stroke unit patients who received predetermined scores on specific items of the National Institutes of Health Stroke Scale were eligible for screening. The trial consisted of three parts (with swallow, cough, and vocal quality observed during each part): 1 teaspoon lemon ice, 1 teaspoon applesauce, and 1 teaspoon water. RNs performed five screenings that were compared with independent screenings performed on the same patient within 1 hour by a speech therapist (ST). Eighty-three paired screenings were completed, with 94% agreement between the RNs and the STs. This screening identifies patients who are able to swallow and can eat from a safe menu until formally evaluated by an ST while maintaining nothing by mouth (NPO) status for those at risk for aspiration.

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