Nursing Interventions for Identifying and Managing Acute Dysphagia are Effective for Improving Patient Outcomes: A Systematic Review Update
Journal of Neuroscience Nursing
Hines, S., Kynoch, K., et al. (2016).
Journal of Neuroscience Nursing, 48(1), 215-223.
This updated systematic review investigates the role of nurse-initiated dysphagia screening in ensuring timely referral to speech-language pathology and/or reduction of dysphagia complications in adults, 18 years and older, with acute neurogenic dysphagia. This summary highlights conclusions of particular interest to speech-language pathologists involving the development and management of dysphagia screening procedures in the acute setting.
Not stated
February 2008 to March 2013
Experimental and epidemiological study designs including: randomized controlled trials; nonrandomized controlled
trials; quasi-experimental studies; before-and-after studies; prospective and retrospective cohort studies; case control studies; cross-sectio
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Three studies examined the use of nursing management strategies for dysphagia. Strategies included: 1) the use of thickened liquids, 2) strategies to improve nursing knowledge and education about dysphagia and 3) strategies for improving nursing processes at admission. Although the findings were limited by a small number of studies, the authors concluded that thickened liquids did not prevent aspiration and that adding nurse-initiated dysphagia screening to the admission process did not significantly improve patient outcomes for rates of chest infection, days spent nil by mouth or inpatient death. However, providing an SLP-led dysphagia education and counseling programs increased the number of nurse-initiated screens and adding nurse-initiate dysphagia screens decreased the number of nutrition consultations and number of transfers to skilled nursing facilities.
Overall findings suggest that nurse-initiated dysphagia screening is effective for detecting dysphagia in acute patients and for reduction of chest infections (odds ratio = 0.45, 95% CI [0.33, 0.62], p < .00001). Results did not definitively indicate whether nurse-initiated dysphagia screenings resulted in faster referral to speech-language pathology, but suggested improved appropriateness of referrals to speech-language pathology,
