Atypical/vague stroke recognition: Expediting the nursing dysphagia screen in the emergency department

46^th Global Nursing & Healthcare

October 15-16, 2018 | Las Vegas, USA

Jennifer Sposito and Annie Worshoufsky

UConn Health, USA

Scientific Tracks Abstracts: Adv Practice Nurs

Abstract :

Statement of the Problem: Stroke is the leading neurological cause of dysphagia (difficulty swallowing). 50% of stroke patients with dysphagia aspirate and 1/3 of those patients develop pneumonia that requires treatment. Early identification of dysphagia post-stroke is a safety goal & a Joint Commission Stroke Center Requirement. Uconn Health became a Primary Stroke Center in 2014, with approximately 200 patients a year and stroke-trained nurses that work on various stroke units. 2016 data identified that 47% of patients with missed dysphagia screen opportunities presented in the Emergency Department (ED) with atypical/ vague stroke symptoms. The purpose of this study was to increase ED nursesâ?? recognition of atypical/vague stroke presentation & implement the stroke clinical pathway which includes an expeditious bedside dysphagia screening. Methodology & Theoretical Orientation: ED nurses were pre-surveyed for baseline knowledge of atypical/vague stroke symptoms. An educational curriculum was provided which included an online learning platform with case scenarios and identification tools. Resource posters addressing knowledge gaps were created. Daily stroke audits were conducted by the stroke coordinator. Staff engagement was reinforced in daily huddles, monthly meetings by ED management and through stroke champions. A post-survey was conducted to assess the newly acquired atypical/vague stroke symptom knowledge and data was analyzed. Findings: In 2017, missed dysphagia screen opportunities in ED patients presenting with atypical/vague stroke symptoms reduced from 47% in 2016 to 17%. Post survey data showed that ED nurses improved in their ability to identify atypical/vague stroke presentation. Conclusion & Significance: Recognition of atypical/vague stroke symptoms leads to an expeditious bedside dysphagia screen in the Emergency Department. This increased patient safety by decreasing the potential risk for aspiration for patients who may experience dysphagia post stroke.

Biography :

Jennifer Sposito, MSN, RN has her expertise in critical care nursing & stroke and passionate in improving the quality of health and wellbeing of this vulnerable population. She had over 10 years’ experience in critical care & 4 as the Stroke Clinical Program Coordinator at her institution. Jennifer also has a master’s degree in public health nursing.

E-mail: otisops34@gmail.com