Staff perceptions following the introduction of a fiberoptic endoscopic evaluation of swallowing service for patients following stroke

Abstract

Fiberoptic endoscopic evaluation of swallowing (FEES^®) is an established tool for assessing dysphagia. However, there has been little investigation of the experiences of healthcare professionals using FEES. This qualitative study investigated staff perceptions one year after the introduction of a FEES service to an acute stroke unit. Six speech-language pathologists (SLPs), three nurses, and one stroke physician participated in semi-structured interviews. Interviews were transcribed and analyzed using qualitative content analysis. Analyses revealed two major themes: (1) the learning curve, and (2) team integration. Staff perceived that having someone with previous experience using FEES was central to establishing the service. Both SLP and non-SLP participants reported an increase in dysphagia knowledge, and for SLPs this new knowledge sometimes challenged previous assumptions. Participants attributed the success of the FEES service to the highly visible nature of FEES and its potential to increase staff collaboration. FEES was perceived as a useful, inter-professional tool for ward-based dysphagia management.

Keywords:

• Qualitative
• Dysphagia
• Stroke
• FEES
• Change management
• Stroke unit

Acknowledgments

The authors appreciate the contributions of Becca Hammond, Waitemata District Health Board, who supported the project and assisted with participant recruitment, Alex Leslie for assistance with transcription and Bianca Gordon for advice with the qualitative analysis.