Nurses' practices in stroke-related dysphagia in low- and middle-income countries.
Kirsten Rowe, Maria N Du Toit, Sarveshvari B Pillay and 1 others
PMID 38572844WHAT IT FOUND
Nurses in low- and middle-income countries sometimes used informal swallowing checks, overlooked silent aspiration risk, and needed more training and speech-language therapist collaboration.
Key findings
01Across eight studies, nurses' dysphagia practices included screening, evaluating swallowing, treatment strategies, monitoring oral intake, referral, and daily care.
02Two studies reported nurses had moderate knowledge of signs and symptoms, and three studies reported they recognised coughing but did not record silent aspiration risk.
03Seven studies identified a need for further training, and five studies identified a need for nurse and speech-language therapist collaboration.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
Only eight studies were included, and sample sizes were small, so the review cannot represent all nurses or all low- and middle-income countries. All studies used non-probability purposive or convenience sampling, so nurses in the studies may not be typical of other settings. Five studies relied on nurses' self-report, so reported knowledge and practices may not match what nurses actually do. The review excluded high-income countries and non-English studies, so it mainly describes English-language hospital studies in low- and middle-income countries. The included studies were observational, not randomised trials, so they describe practices and needs rather than prove that training or collaboration improves patient outcomes.
Declared interests
The authors reported that the research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.
The easy way to misread this
Do not read this as proof that dysphagia training or nurse-SLT collaboration improves patient outcomes. The review synthesised observational studies, many based on nurses' self-report, and did not test whether these practices reduce aspiration pneumonia or death.