297 Re-audit of Swallow Assessment in Acute Stroke Patients Following Introduction of a Full-time Speech Specialist

Abstract

Abstract Background The National Clinical Guidelines and Recommendations for the Care of People with Stroke recommend that if an initial screen of a patient with an acute stroke indicates swallowing difficulties, the patient should have a specialist swallow assessment within 24 hours of admission and not more than 72 hours afterwards. The aim of this audit was to reassess the rate of specialist assessment in this patient group following the introduction of a full-time speech specialist in an acute hospital. Methods This was a clinical audit where all patients who presented with acute stroke, where initial swallow screening indicated problems were reviewed. Data was collected from medical records over a twelve week period from January 2019-April 2019. Results Twenty patients presented with an acute stroke, with initial assessment indicating swallow problems; 12 male, 8 female. Mean age was 72 years (ranging from 41 to 96). Eight of these were seen by a speech and language therapist (SALT) within 72 hours; 7 were assessed by SALT <24 hours and 1 was assessed within the 48-72-hour window. Of those seen by SALT; -2 were placed on a normal diet, 2 nil by mouth (NPO), 4 were placed on a modified diet. Two patients were reassessed (3 and 2 times respectively). Of the patients assessed by SALT, 1 passed away and 7 were discharged home (2 referred to community SALT follow-up). When compared with a previous audit in 2018, swallow assessment by SALT < 72 hours has increased from 14% to 40%. The National Stroke Audit has recorded rates of 37%. Conclusion Introduction of a full-time speech and language specialist has increased the rates of swallow assessment in line with the national average. The overall rates of SALT interventions in dietary regimens highlights the need to increase overall assessment rates in patients with acute stroke.