Effectiveness of Early Dysphagia Screening in Reducing Stroke-Related Pneumonia

Stroke-Related Complications such as Pneumonia Affect Patients' Health
Introduction
Stroke-related complications such as pneumonia affect patients' health outcomes and quality of life. The prevalence of stroke-related pneumonia is about 14% (Eltringham et al., 2020), and dysphagia is one of the key risk factors for stroke-associated pneumonia (Feng et al., 2019). Therefore, it is crucial to identify patients at risk of developing dysphagia and its associated aspiration pneumonia.
Purpose of the Project
The project's purpose was to establish the effectiveness of early dysphagia screening in reducing stroke-related pneumonia.
Significance of the Project
The findings from the study provide evidence of good nursing care interventions based on established evidence. The project also adds to the existing literature on dysphagia screening. Finally, the project supports evidence-based practice and inter-professional collaboration in dysphagia management among stroke patients.
Literature Review
The main findings from the literature review were as follows:
* Early dysphagia screening involves screening within the first 24 hours of hospital admission (Grossmann et al., 2021; Eltringham et al., 2018). After 24 hours, the risk of stroke-associated pneumonia increases by 4% (Bray et al., 2017).
* The incidence of dysphagia among stroke patients is significantly high. The incidence rate varies between 50% and 80% (Kim et al., 2020) and 8% to 80% depending on assessment and methodology (Oliveira et al., 2019).
* The key predictors of dysphagia and dysphagia screening in stroke patients are the severity of the stroke, admission to stroke units, older age, male gender, and history of stroke (Joundi et al., 2017; Liang et al., 2022; Jones et al., 2020; Rofes et al., 2018).
* The risk of stroke-associated pneumonia is highly associated with dysphagia. The prevalence of developing stroke-associated pneumonia when a patient has dysphagia is 22%, while when a patient has no dysphagia is 2% (Pacheco-Castilho et al., 2019).
* Dysphagia screening reduces the risk of stroke-associated pneumonia and improves other health outcomes (Sivertsen et al., 2017; Schrock et al., 2017; Yang et al., 2021; Perry et al., 2019; Sherman et al., 2021). Further research is necessary to provide substantial evidence and increase adherence to early dysphagia screening.
Methods
Design
A qualitative approach was employed to provide a deeper insight into the effectiveness of early dysphagia screening in the reduction of stoke-related pneumonia. It ensures meaning from the words of participants can be found (Grove & Gray, 2019).
Setting
The project was carried out in emergency rooms, rehabilitation facilities, and stroke units. Stroke patients often receive care in these healthcare settings.
Participants
The project's participants included nurses providing care to stroke patients in emergency rooms, rehabilitation facilities, and stroke units. They were selected using purposive sampling, which allows conscious selection of participants to ensure rich information about the phenomenon is obtained (Gray & Grove, 2021). The inclusion criteria were: registered nurses, experience working with stroke patients, and availability for the duration of the project. A total of 20 participants were selected.
Data Collection Methods
Interviews and surveys were used in data collection. Interviews were deemed appropriate because they were convenient for participants (Grove & Gray, 2019). Participants were asked open-ended-questions that allowed further probing to obtain more information (Grove & Gray, 2019). The interviews took 30-40 minutes and were recorded on the interviewer’s smartphone. Verbatim transcription was used to transcribe the interviews.
Surveys were also deemed appropriate because of their effectiveness in collecting data about the nursing practice (Munn & Jones, 2020). The surveys were handed out to participants to increase the response rate. The completion of a survey took 15-20 minutes. In both the interviews and surveys, participants were asked to report their dysphagia screening among stroke patients using the water wallow test (appendix A and B).
Discussion
Findings
The number of fails and passes among screened patients was recorded. The project revealed that most patients who passed the water swallow test did not aspire, and most of those who failed the screening developed stroke-related pneumonia. The project's findings align with those in the literature, indicating that dysphagia screening effectively prevents stroke-associated pneumonia. The project also revealed that the complexity or ease of dysphagia screening influences nurses’ incorporation of early screening into routine practice.
Limitations
Differences in the project's setting contributed to dysphagia screening proto...