Nurses' preferred items for dysphagia screening in acute stroke patients: A qualitative study

Formal dysphagia screening protocols are not yet implemented in some hospitals although there is growing evidence that early dysphagia screening reduces pneumonia rates in stroke patients. Trained professionals are not often available outside weekdays working hours in stroke units, meaning that early screening is usually performed by nurses that use informal detection to screen dysphagia in acute stroke patients. The purpose of this study was to identify which items stroke nurses prioritize in their clinical practice to screen dysphagia in acute stroke patients.

A qualitative study was developed using a focus group technique in five stroke units with a total of 20 stroke nurses selected by purposive sampling in march 2019. Qualitative Data Analysis Software Miner Lite 4.0 was used to assist in content analysis.

Two categories emerged: clinical data and swallowing and non-swallowing signs, each with a set of dimensions. In the category clinical data, relevance was noted for the dimension Glasgow Coma Scale and sex, identified as the most and least relevant, respectively, for dysphagia screening. In the category swallowing and non-swallowing signs no relevance evolved for preferred items. However, in this category, data suggest that nurses find less relevant in clinical practice speech disorders for dysphagia screening.

Results reinforce the importance of a standardized approach through the use of valid and reliable dysphagia screening protocols, arguing the need for clear guidance in acute stroke clinical pathways on procedures for dysphagia screening.