Implementation of hospital wide dysphagia screening in a large acute tertiary teaching hospital

Abstract

Purpose: There are no examples in the literature of successful long-term hospital-wide implementation of nurse-led dysphagia screening. This article aims to describe strategies used to implement hospital-wide dysphagia screening in a large acute tertiary teaching hospital in Australia. It reports on compliance, accuracy and nursing staff satisfaction using the validated Royal Brisbane and Women’s Hospital Dysphagia Screening Tool (RBWH DST).

Method: A retrospective observational study of audit data was conducted to examine hospital-wide compliance and accuracy of dysphagia screen completion. A nursing staff survey measured staff satisfaction. Implementation included: (1) utilisation of validated tool (RBWH DST); (2) key stakeholder engagement and strong governance; (3) policy development; (4) education; and (5) review and monitoring processes.

Result: Audits conducted over a 9-year period (n = 3726) showed an average hospital-wide compliance rate of 74% and an accuracy rate of 82%. A nurse satisfaction survey (n = 109) showed high levels of satisfaction associated with using the RBWH DST.

Conclusion: The RBWH DST was implemented in a large acute tertiary teaching hospital with acceptable compliance and accuracy rates and favourable nursing staff satisfaction. Further study is required to objectively evaluate patient health and cost benefits associated with using the RBWH DST.

Keywords:

• Dysphagia
• deglutition
• screening
• risk assessment
• hospital

Acknowledgements

The authors of original study (Cicero, Heaton & Bassett 2009) are acknowledged for their contribution to the concepts and content of the RBWH Dysphagia Screening Tool, and for their involvement with the validation and publication of the original study. Members of the SPD are gratefully acknowledged for their ongoing contribution to the education and auditing process. Various key stakeholders, committees and working groups are acknowledged for their support and endorsement of hospital-wide implementation of dysphagia screening. We are grateful to the nursing staff for their crucial role and dedication to the dysphagia screening process.

Ethics approval

The study protocol was approved by Human Research Ethics Committee, Royal Brisbane and Women’s Hospital.

Declaration of interest

The authors report no conflict of interest. The authors alone are responsible for the content and writing of this paper.

Supplementary material

Supplemental data for this article can be accessed at https://doi.org/10.1080/17549507.2019.1597922.