A vision for dysphagia screening by nurses
Petra Mandysová
Faculty of Health Studies, University of Pardubice
Abstract
MANDYSOVÁ, P. A vision for dysphagia screening by nurses. In Ošetrovateľstvo: teória, výskum, vzdelávanie [online], 2014, vol. 4, no. 1, pp. 37-41. Available on: https://www.osetrovatelstvo.eu/archiv/2014-rocnik-4/cislo-1/a-vision-for-dysphagia-screening-by-nurses.
Aim: The aim was to develop and implement in practice a simple nursing dysphagia screening tool (NDST).
Methods and Sample: In Phase 1, a total of 157 patients prone to dysphagia underwent a nursing swallowing assessment (32 items). The results were compared with the objective flexible endoscopic examination of swallowing (FEES). Nursing assessment items with a statistically significant relationship to FEES became the NDST items. In Phase 2, the effectiveness of an educational session on the NDST’s correct use was studied, using a knowledge post-test. Seventy nurses or university students attended the session. In Phase 3, the NDST’s inter-rater reliability was studied on a sample of 42 patients with cerebrovascular accident, using coefficient kappa (κ).
Results: Eight items were selected for the NDST; its sensitivity (95.5%) and negative predictive value (88.9%) were high in the neurological subgroup. The average success rate of the knowledge post-test was 73.8%. The overall inter-rater reliability was low (κ = 0.264; p = 0.047); however, substantial agreement was reached for selected items.
Conclusion: The NDST is the only dysphagia screening tool developed in the Czech Republic; its diagnostic criteria are high. Current work focuses on fine-tuning education and supporting its implementation.
Keywords: dysphagia, inter-rater reliability, nursing assessment, screening tool, swallowing
Contact
Petra Mandysová, MSN, Ph.D.
Faculty of Health Studies, University of Pardubice
Průmyslová 395
532 10 Pardubice
Czech Republic
email: Petra.Mandysova@upce.cz
Prijaté: 21. 3. 2014
Akceptované: 28. 4. 2014