2.50
Hdl Handle:
http://hdl.handle.net/10755/198358
Title:
Dysphagia Screening in the Emergency Department: How We Increased Compliance
Abstract:
[ENA Annual Conference 2011 - Evidence-based Practice Presentation] Dysphagia Screening in the Emergency Department: How We Increased Compliance

Purpose: According to the Get with the Guidelines database one of the important core measures is dysphagia screening, a tool to identify patients at risk for aspiration due to swallowing impairment post stroke. It was recognized that most screening needed to take place in the ER before oral meds and nutrition were initiated.

Design: A team, including speech therapy, the ER and staff from our stroke floor, met to tackle the problem of low compliance.

Setting: Urban Community Hospital in a suburb of New York City. The ER sees approximately 60,000 patients per year.

Participants/Subjects: All patients whose final diagnosis was either stroke or TIA were included in the retrospective analysis, used to identify prospective candidates for future inclusion for screening.

Methods: Two issues were identified. The first dilemma was to identify who needed the screening. The team developed a master list of diagnoses that may be related to stroke. They then linked this to a list of chief complaints (a statement about why a patient presents to the ER seeking treatment). The second issue was documentation. Initially, the dysphagia screen was on paper, and the actual implementation was long and cumbersome. When this screen was computerized charting became a major effort, and compliance, which was erratic, fell. The prevailing philosophy was feed no one, and let the nurses upstairs do the screening. The team streamlined the actual screening to be more user-friendly while remaining in compliance with national guidelines. Through one-to-one interactions with ED managers, staff meetings and email/printed material, the ED staff was in-serviced to expect that the dysphagia screen would be appearing on documentation screens more frequently. The rationale for its addition as a required assessment for certain Chief Complaints was also communicated.
Results/Outcomes: The hospital now boasts over 90% compliance consistently & many months have even reached 100% perfection!

Implications: A process that was once dreaded has become as second nature as crossing a T! Compliance has ensured patient safety and raised the level the care being delivered in the ER.

Repository Posting Date:
21-Dec-2011
Date of Publication:
21-Dec-2011

Full metadata record

DC FieldValue Language
dc.titleDysphagia Screening in the Emergency Department: How We Increased Complianceen_GB
dc.identifier.urihttp://hdl.handle.net/10755/198358-
dc.description.abstract[ENA Annual Conference 2011 - Evidence-based Practice Presentation] Dysphagia Screening in the Emergency Department: How We Increased Compliance<br/><br/>Purpose: According to the Get with the Guidelines database one of the important core measures is dysphagia screening, a tool to identify patients at risk for aspiration due to swallowing impairment post stroke. It was recognized that most screening needed to take place in the ER before oral meds and nutrition were initiated.<br/><br/>Design: A team, including speech therapy, the ER and staff from our stroke floor, met to tackle the problem of low compliance. <br/><br/>Setting: Urban Community Hospital in a suburb of New York City. The ER sees approximately 60,000 patients per year.<br/><br/>Participants/Subjects: All patients whose final diagnosis was either stroke or TIA were included in the retrospective analysis, used to identify prospective candidates for future inclusion for screening.<br/><br/>Methods: Two issues were identified. The first dilemma was to identify who needed the screening. The team developed a master list of diagnoses that may be related to stroke. They then linked this to a list of chief complaints (a statement about why a patient presents to the ER seeking treatment). The second issue was documentation. Initially, the dysphagia screen was on paper, and the actual implementation was long and cumbersome. When this screen was computerized charting became a major effort, and compliance, which was erratic, fell. The prevailing philosophy was feed no one, and let the nurses upstairs do the screening. The team streamlined the actual screening to be more user-friendly while remaining in compliance with national guidelines. Through one-to-one interactions with ED managers, staff meetings and email/printed material, the ED staff was in-serviced to expect that the dysphagia screen would be appearing on documentation screens more frequently. The rationale for its addition as a required assessment for certain Chief Complaints was also communicated.<br/>Results/Outcomes: The hospital now boasts over 90% compliance consistently & many months have even reached 100% perfection!<br/><br/>Implications: A process that was once dreaded has become as second nature as crossing a T! Compliance has ensured patient safety and raised the level the care being delivered in the ER. <br/><br/>en_GB
dc.date.available2011-12-21T12:47:18Z-
dc.date.issued2011-12-21T12:47:18Z-
dc.date.accessioned2011-12-21T12:47:18Z-
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