Developing and Testing a Bedside Aspiration Screen to Protect Stroke Patients From Aspiration and Mortality: Expanding Nursing Practice and Partnership

Abstract

Stroke is the 4th leading cause of death in the United States at a rate of 1 death every 4 min. Stroke patients initially experience dysphagia 42%–76% of the time, putting them at high risk for developing aspiration pneumonia, increasing the risk of death three-fold in the first 30 days following onset of the condition. The Edith-Huhn-Matesic Bedside Aspiration Screen (EHMBAS) was developed as an evidence-based registered nurse (RN) bedside aspiration screening protocol. It represents an example where a strategic training program and multidisciplinary collaboration enabled nurses to broaden their education and scope of practice to improve care to the stroke population on the acute stroke unit. As recommended by the Institute of Medicine (2011) report, nurses advanced the health of stroke patients. The EHMBAS demonstrated strong validity (94% sensitivity) and high interrater reliability (Kappa = .92, p < .001). Pre- and poststaff training survey results verified a significant positive change in knowledge gained, preparedness, and satisfaction with teaching methods. Furthermore, 92.3% of patients surveyed had positive screening experiences. The multidisciplinary stroke team was highly effective at implementing stroke guidelines expeditiously, saving lives in this population. This study was significant in that it contributed to the body of work aimed at establishing a sustainable valid, and reliable evidence-based, bedside aspiration screen that can be promptly completed for acute stroke victims.