Abstract WP379: Interdisciplinary Collaboration Sustains the Utilization of an Evidenced-based Dysphagia Screening Protocol

Abstract

Background and Purpose: During implementation of an acute stroke program, areas in need of improvement were observed, including dysphagia screening, appropriate intervention and documentation. An interdisciplinary team, including a Speech Language Pathologist (SLP), selected the Yale Swallow Protocol to be used by the bedside nurse to screen patients with stroke symptoms. The Yale Swallow Protocol is a validated tool for dysphagia screening. The purpose of this project was to validate the effectiveness of using interdisciplinary collaboration to sustain the utilization of an evidence-based dysphagia screening protocol. Methods: Patient’s presenting with stroke symptoms are to receive a dysphagia screen within 24 hours of hospital arrival. Screening results are then to be documented in the Electronic Medical Record (EMR). Patient data abstraction revealed inconsistent application of the Yale Swallow Protocol. The interdisciplinary team then developed a training tool focused on the protocol. The SLP utilized this tool to train nurses on the protocol, appropriate intervention and documentation. Patient dysphagia screening data abstraction from the patient EMR was tabulated to include the percentage of completed documentation. The goal was a minimum average of 90% for four months. The benchmark is set by Joint Commission’s evidence of standards compliance - measures of success. Results: The results demonstrated sustained improvement. Eight months prior to intervention, the average dysphagia screen documentation was 85% of 203 patients. The first 3 months’ post intervention the average rate of documentation was 93% of 91 patients. The next 5 months’ post intervention demonstrated sustained and improved compliance with the average documentation at 97% of 133 patients. With a total 8-month cumulative average of 96% of 224 patients. Conclusions: In conclusion, the positive patient data trend demonstrates the continual utilization of the screen post intervention. Utilizing interdisciplinary collaborative efforts will yield results that are sustainable when continual awareness and educational efforts are deliberate and ongoing.