Oral intake of solid medications in patients with post-stroke dysphagia. A challenge for nurses?
Michaela Trapl-Grundschober, Steffen Schulz, Simon Sollereder and 3 others
PMID 38407372WHAT IT FOUND
Nurses in stroke units reported avoiding whole tablets or capsules in suspected acute dysphagia.
Many preferred non-oral routes, but some crushed or divided tablets, often using apple sauce or yoghurt.
Key findings
01No nurse said they would give solid oral medication to a stroke patient with suspected acute dysphagia, but 32.2% said they would give modified medication.
02In the Gugging Swallowing Screen group, severe dysphagia scores meant no oral medication, while 10 nurses said they gave solid drugs to mildly impaired patients.
03Apple sauce, yoghurt and thickened water were the most common accompanying boluses for medication delivery, with apple sauce named in 124 responses.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The nurses were recruited by convenience and snowball methods, so the sample may not represent all stroke-unit nurses. Multiple nurses from the same stroke unit could have answered, so unit-level practice may be overcounted. The study is cross-sectional and self-reported, so it describes what nurses said they do, not what they actually did. It did not measure patient swallowing outcomes, aspiration, medication absorption or errors. Many questions allowed multiple answers and some nurses skipped items, so response totals vary.
Declared interests
The authors declare no conflicts of interest. The paper does not report funding.
The easy way to misread this
Do not read these percentages as evidence that crushing tablets or giving medicines with apple sauce, yoghurt or thickened water is safe. The study surveyed nurses' reported practices, not patient swallowing outcomes or medication absorption.