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Rapid Aspiration Screening for Suspected Stroke

Part 2: Initial and Sustained Nurse Accuracy and Reliability
Published:April 23, 2016DOI:https://doi.org/10.1016/j.apmr.2016.03.024

      Abstract

      Objective

      To determine registered nurses' (RNs') ability to obtain and maintain accurate procedural skills and reliable interpretation of the screening items under study to develop the Rapid Aspiration Screening for Suspected Stroke.

      Design

      Prospective, observation study.

      Setting

      A certified primary stroke center in a major metropolitan medical facility.

      Participants

      RNs (N=15) were recruited and trained in the administration and interpretation of the screening items under study to develop the Rapid Aspiration Screening for Suspected Stroke.

      Interventions

      RNs completed a total of 239 screenings of patients admitted with suspected stroke over a 2-year period. RNs administered the swallowing screening items and interpreted the patient's response to each item. Independent of the RN, a speech-language pathologist simultaneously interpreted the response of the participant with stroke to each swallowing screening item.

      Main Outcome Measures

      Reliability of the interpretation and accuracy of the administration of the swallowing screening items.

      Results

      The average accuracy rate for the administration of the Rapid Aspiration Screening for Suspected Stroke was 98.33%, with the overall accuracy rate for each procedural task ranging from 95.42% to 100%. For the specific swallowing screening items that formed the Rapid Aspiration Screening for Suspected Stroke, dysarthria and a positive sign after water swallow, reliability was high (k=.817). The accuracy rate for the administration and reliability of the interpretation of the swallowing screening items improved as RNs gained experience, and both were maximized at 20 screening opportunities.

      Conclusions

      RNs demonstrate both excellent accuracy of procedural administration and reliability of interpretation of the items of the Rapid Aspiration Screening for Suspected Stroke. With feedback and repeated opportunities to practice, maintenance of skills is achievable.

      Keywords

      List of abbreviations:

      ED (emergency department), RN (registered nurse), SLP (speech-language pathologist), SST (swallowing screening tool), VFSS (videofluoroscopic swallowing study)
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      References

        • Edmiaston J.
        • Connor L.T.
        • Loehr L.
        • Nassief A.
        Validation of a dysphagia screening tool in acute stroke patients.
        Am J Crit Care. 2010; 19: 357-364
        • Martino R.
        • Silver F.
        • Teasell R.
        • et al.
        The Toronto Bedside Swallowing Screening Test (TOR-BSST): development and validation of a dysphagia screening tool for patients with stroke.
        Stroke. 2009; 40: 555-561
        • Warner H.L.
        • Suiter D.M.
        • Nystrom K.V.
        • Poskus K.
        • Leder S.B.
        Comparing accuracy of the Yale swallow protocol when administered by registered nurses and speech-language pathologists.
        J Clin Nurs. 2013; 23: 1908-1915
        • Daniels S.K.
        • Pathak S.
        • Rosenbek J.C.
        • Morgan R.O.
        • Anderson J.A.
        Rapid Aspiration Screening for Suspected Stroke: part 1: development and validation.
        Arch Phys Med Rehabil. 2016; 97: 1440-1448
        • Daniels S.K.
        • Pathak S.
        • Stach C.B.
        • Mohr T.M.
        • Morgan R.O.
        • Anderson J.A.
        Speech pathology reliability for stroke swallowing screening items.
        Dysphagia. 2015; 30: 565-570
        • Cohen A.K.
        Creating a swallow screening program at Mass General Hospital: a model for development and implementation.
        Perspect Swal Swal Disord (Dysph). 2009; 18: 123-128
        • Cichero J.A.
        • Heaton S.
        • Bassett L.
        Triaging dysphagia: nurse screening for dysphagia in an acute hospital.
        J Clin Nurs. 2009; 18: 1649-1659
        • Freeland T.R.
        • Pathak S.
        • Garrett R.R.
        • Anderson J.A.
        • Daniels S.K.
        Using medical mannequins to train nurses in stroke swallowing screening.
        Dysphagia. 2016; 31: 104-110
        • Daniels S.K.
        • Anderson J.A.
        • Petersen N.J.
        Implementation of stroke dysphagia screening in the emergency department.
        Nurs Res Pract. 2013; 2013: 304190