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Swallow Evaluation Tool to Reduce Aspiration among Acute Stroke Patients
Other Titles
Swallow Evaluation ToolAbstract
Problem & Purpose: Dysphagia, a common yet often underdiagnosed neurological symptom after an acute stroke, can lead to life-threatening aspiration pneumonia. A three-month chart review at the project site revealed 42.5% incidence of aspiration among acute stroke patients, necessitating additional intervention and cost for stabilization. Literature suggests that early dysphagia screening using a validated tool is associated with decreased aspiration and complications. However, the project site employed a screening tool that lacks validation, and completion within 24 hours was less than 50%. This quality improvement initiative aimed to reduce aspiration among acute stroke patients by implementing the Yale Swallow Protocol tool (YSP), within 24 hours of admission. Methods: Over a 15-week implementation period in the fall of 2023, at a stroke-certified neuro intermediate care unit, the YSP tool was included in the nurses' admission bundle. All eligible patients screened using the YSP tool were referred to a speech-language pathologist (SLP) if failed the test. Nurses received education prior to and during implementation. Weekly audits assessed the number of patients screened and the utilization of the YSP tool. Result: Out of 63 eligible patients: 37 were screened within 24 hours of admission, 29 met exclusion criteria and failed the screening tool in step 1, 4 who failed in step 2 were referred to SLP reevaluation. 4 passed for a regular diet. Overall, there were 59% compliance with using the tool. Three patients were identified with aspiration pneumonia. Conclusion: YSP is a quick, easy-to-follow, and effective tool to screen acute stroke patients within 24 hours of admission. Further studies should explore its implementation in other areas including the Emergency Department where acute stroke patients are initially encountered. Nurses can safely utilize the tool with ongoing education on aspiration prevention. Key words: swallow evaluation tool, aspiration, aspiration pneumonia, acute stroke.Keyword
Yale Swallow Protocol (YSP)swallow evaluation tool
Deglutition Disorders
Stroke
Pneumonia, Aspiration
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http://hdl.handle.net/10713/22789Collections
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