Implementation strategies to improve evidence-based practice for post-stroke dysphagia identification and management: A before-and-after study.
Xiaoyan Zhang, Junqiang Zhao, Liping Zheng and 2 others
PMID 35891917WHAT IT FOUND
Better patient swallowing quality of life and satisfaction were reported after nurses received training, standardized dysphagia processes, and weekly audit and feedback; nurse knowledge and adherence also improved.
Key findings
01Patient total mean SWAL-QOL score was 120.43 before and 143.78 after, and satisfaction was 97.22 before and 98.68 after; the study reported both as significant.
02Nurse total mean knowledge score was 35.06 before and 59.41 after, reported as significant.
03Adherence improved significantly on 13 audit items.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study included only 17 nurses and 28 or 27 patients in one rehabilitation unit in a community hospital in China. It was a before-and-after study with different patient groups, so time-related changes may have contributed. The training, policy, and audit and feedback strategies were delivered together, so their individual effects could not be separated. Follow-up was about five months, so it is unknown whether improvements lasted longer. Patients with cognitive impairment, severe complications, intermittent tube feeding, or other throat diseases were excluded. The nurse knowledge test, patient satisfaction questionnaire, and audit tool were developed by the research team, and one SWAL-QOL scale had reliability of 0.48 against a 0.70 standard.
Declared interests
The authors declared no conflict of interest. The work was supported by a postgraduate independent project of Beijing University of Chinese Medicine.
The easy way to misread this
Do not conclude that training, policy, or audit and feedback each caused the improvements. All three were delivered together, and the study could not separate their effects.