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Evaluating a novel approach to enhancing dysphagia management: workplace-based, blended e-learning

Authors

  • Irene Ilott DipCOT, MEd, PhD,

    Knowledge Translation Project Lead, Corresponding author
    1. NIHR CLAHRCSY, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
    • Correspondence: Irene Ilott, NIHR CLAHRC SY, Sheffield Teaching Hospitals NHS Foundation Trust, 11 Broomfield Road, Sheffield, S10 2SE, UK. Telephone: +44 114 226 8465.

      E-mail: Irene.Ilott@sth.nhs.uk

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  • Bev Bennett RN, PgDipEd, DMedSci,

    Senior Lecturer
    1. Faculty of Health and Wellbeing, Sheffield Hallam University, Sheffield, UK
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  • Kate Gerrish RN, MSc, PhD,

    Professor of Nursing Research
    1. School of Nursing and Midwifery, University of Sheffield/Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
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  • Sue Pownall BSc, PhD,

    Acting Head of Speech and Language Therapy
    1. Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
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  • Amanda Jones RN,

    Stroke Nurse Consultant
    1. Sheffield Teaching Hospitals NHS Foundation Trust, Royal Hallamshire Hospital, Sheffield, UK
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  • Andrew Garth BEd, MA

    Senior Lecturer
    1. Sheffield Hallam University, Sheffield, UK
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Abstract

Aims and objectives

To evaluate the learning effect and resource use cost of workplace-based, blended e-learning about dysphagia for stroke rehabilitation nurses.

Background

Dysphagia is a potentially life-threatening problem that compromises quality of life. In many countries, nurses play a crucial role in supporting the management of patients with swallowing problems, yet the literature reports a need for training.

Design

A single-group, pre- and post-study with mixed methods.

Methods

Each blended e-learning session comprised a needs analysis, e-learning programmes, practical skills about modifying fluids and action planning to transfer learning into practice. Participants were the population of registered nurses (n = 22) and healthcare assistants (n = 10) on a stroke rehabilitation ward in a large, teaching hospital in England between August 2010–March 2011. Data collection comprised observation (34 hours), questionnaires administered at four time points to examine change in attitude, knowledge and practice, and estimating the resource use cost for the service. Nonparametric tests and content analysis were used to analyse the data.

Results

All participants achieved a nationally recognised level of competence. The learning effect was evident on the post- and follow-up measures, with some items of dysphagia knowledge and attitude achieving significance at the p ≤ 0·05 level. The most common self-reported changes in practice related to medicines management, thickening fluids and oral hygiene. The resource use cost was estimated at £2688 for 108 hours training.

Conclusions

Workplace-based, blended e-learning was an acceptable, cost effective way of delivering essential clinical knowledge and skills about dysphagia.

Relevance to clinical practice

Dysphagia should be viewed as a patient safety issue because of the risks of malnutrition, dehydration and aspiration pneumonia. As such, it is pertinent to many members of the interdisciplinary team. Consideration should be given to including dysphagia management in initial education and continuing professional development programmes.

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