Application of the best evidence of dysphagia recognition in acute stroke patients / 中国实用护理杂志

ABSTRACT

Objective:To study the application of the best evidence of dysphagia recognition in acute stroke patients.Methods:The study was performed guided by JBI evidence-based continuous quality improvement pattern, including evidence acquisition, baseline audit, evidence implementation and re-audit. Data were collected by using field observation, questionnaire survey and review of nursing records. 80 patients and 18 nurses were recruited in the study. Barriers to evidence implementation and available solutions were analyzed. Before and after the application of evidence, the compliance of audit criterion, screening rate of swallowing disorder, screening accuracy, screening record rate and knowledge of nurses were compared.Results:Before and after the implementation of evidence, the compliance of all audit criterion was 0-33.3% and 95.0%-100.0%, and had a significant difference ( P<0.05). The dysphagia recognition knowledge score was improved from 40-80(60.56±10.69) to 60-100 (82.78±10.18) and had a significant difference ( t value was -6.39, P<0.05). The screening rate for dysphagia increased from 7.5% to 95.0%, with statistically significant difference ( χ2 value was 119.10, P<0.05). The screening accuracy was 100%, and the screening record rate was 97.4%, only 4 of the 24 patients at risk of dysphagia developed pulmonary infection. Conclusion:The application of the best evidence of dysphagia recognition in acute stroke patients can improve the nurses′ ability of dysphagia screening and improve nursing practice in dysphagia management.