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)To read this article in full you will need to make a payment
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References
- Validation of a dysphagia screening tool in acute stroke patients.Am J Crit Care. 2010; 19: 357-364
- 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
- Comparing accuracy of the Yale swallow protocol when administered by registered nurses and speech-language pathologists.J Clin Nurs. 2013; 23: 1908-1915
- Rapid Aspiration Screening for Suspected Stroke: part 1: development and validation.Arch Phys Med Rehabil. 2016; 97: 1440-1448
- Speech pathology reliability for stroke swallowing screening items.Dysphagia. 2015; 30: 565-570
- Creating a swallow screening program at Mass General Hospital: a model for development and implementation.Perspect Swal Swal Disord (Dysph). 2009; 18: 123-128
- Triaging dysphagia: nurse screening for dysphagia in an acute hospital.J Clin Nurs. 2009; 18: 1649-1659
- Using medical mannequins to train nurses in stroke swallowing screening.Dysphagia. 2016; 31: 104-110
- Implementation of stroke dysphagia screening in the emergency department.Nurs Res Pract. 2013; 2013: 304190
Article Info
Publication History
Published online: April 23, 2016
Footnotes
Supported by a Merit Award (award no. 1I0RX00121) from the Rehabilitation Research and Development of the Veterans Affairs Office of Research and Development Service. The views expressed in this article are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs or the University of Texas School of Public Health.
Disclosures: S.P., J.C.R., R.O.M., and S.K.D. received salary support from the Merit Award (award no. 1I0RX00121) from the Rehabilitation Research and Development of the Veterans Affairs Office of Research and Development Service. J.A.A. has nothing to disclose.
Identification
Copyright
Published by Elsevier Inc. on behalf of the American Congress of Rehabilitation Medicine
