Abstract WP466: Improving Stroke Dysphagia Screening Core Measure Compliance and Patient Outcomes

Abstract

Background and Issues: Prior to this project, an internally created dysphagia screen had been used. A validated stroke dysphagia screen was needed. Knowledge deficits existed on who, when, and how to perform the screen. With record patient census, stroke patients got admitted wherever there was an open bed, so all units needed this education. Evidence also showed that swallowing issues were related to aspiration. Purpose: Evaluate the impact of expanded education and use of a validated stroke dysphagia screen on core measure compliance and hospital acquired pneumonia incidence on stoke/TIA patients. Methods: An interprofessional team selected the validated, stroke dysphagia screen. Education was provided via an online module, tipsheets, and live demonstrations. More resources and demonstration videos were made available on the internal stroke program website. All inpatient stroke/TIA patients were monitored for core measure compliance at least 4 days/week, with real time follow-up to involved nurses as needed. The stroke core measure of dysphagia screening compliance and documentation of hospital-acquired aspiration pneumonia was entered into a database for 100% of the coded stroke/TIA patients during the study periods (i.e. July-December over 2 years: Baseline= 2016 and Intervention=2017). Results: More than 2000 nurses attended the live presentations and/or completed the online module. Compliance and outcome findings were as follows: Conclusions: Though no direct cause and effect with the pneumonia results can be proven with this quality improvement effort, favorable findings occurred. The percentage of stroke/TIA patients being screened went up and the percentage of those patients developing hospital acquired pneumonia went down after the screening tool change, education, and monitoring process were put into place.