A tool has been developed which immediately identifies stroke patients with swallowing difficulties at their bedside.

The simple test, which can be performed at the bedside by nursing staff, could now be implemented across the whole of Wales in an attempt to help the NHS hit Welsh Government targets for the care of stroke patients.

There lacked a universal method to screen for signs of swallowing impairment following stroke, with different hospitals in England and Wales reportedly using significantly different methods. Until now, many inpatients are kept in a “nil by mouth” state as they wait for a swallowing assessment to be carried out. This blanket policy means that long waits can occur in the case of staff absences or shortages.

In an attempt to improve this, The Royal College of Physicians has since recommended all newly-diagnosed stroke patients have their swallow screened within 24 hours of hospitalisation.

It is thought that swallowing difficulties affect up to 68% of stroke sufferers, although the symptoms may not be immediately apparent. The dangers of not identifying difficulty in swallowing in patients who have had a stroke can include the entry of materials into the lungs which can cause pneumonia and even death.

Developed by Speech and Language Therapist (SLT) Dr Kathryn Head, with the University of Glamorgan, it is currently being used in hospitals run by Cwm Taf Health Board. The screening tool has won a MediWales award, which recognises excellence in Welsh life sciences.

The “triage” test, helps to identify which patients require assessment by an SLT and checks whether patients are fully conscious to accept oral feeding and timing the patient drinking a quantified volume of water. The overall aim of the toolkit is to prevent acute stroke patients with normal swallows being placed nil by mouth and to prevent patients who have difficulty swallowing from being fed inappropriately.

“Evidently, steps taken to address the prevention of malnutrition and complications of having a difficulty in swallowing, which include aspiration pneumonia, dehydration, morbidity, mortality and implied costs are critical” said Dr Head.

Dr Chris Jones, chair of Cwm Taf Health Board, said that the tool was already beginning to demonstrate actual benefits for patients.“The challenge for us now is to roll this out further” he said.

Original Source WalesOnline

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