Management of swallowing in thrombolysed stroke patients : Implementation of a new protocol

Journal article


Schwarz, Maria, Coccetti, Anne, Cardell, Elizabeth, Murdoch, Allison and Davis, Jennifer. (2017). Management of swallowing in thrombolysed stroke patients : Implementation of a new protocol. International Journal of Speech-Language Pathology. 19(6), pp. 551-561. https://doi.org/10.1080/17549507.2016.1221457
AuthorsSchwarz, Maria, Coccetti, Anne, Cardell, Elizabeth, Murdoch, Allison and Davis, Jennifer
Abstract

Purpose: There is a paucity of evidence regarding dysphagia management post-thrombolysis. The aim of this case–control study was to evaluate the impact of a dysphagia management protocol on patient outcomes. Thrombolysis has been completed at our metropolitan hospital since 2011 and a dysphagia management protocol was developed in 2012.

Method: Chart auditing was completed for 83 participants in three groups: pre-protocol (n = 12) (2011), post-protocol (n = 28) (2012–2014), and non-thrombolysed stroke patients (n = 43).

Result: Following the implementation of this clinical protocol, the average time patient remained nil by mouth reduced by 9.5 h, the percentage of patients who were malnourished or at risk reduced by 24% and the number of patients who developed aspiration pneumonia reduced by 11%. The cost of hospital stay reduced by $1505. Service compliance with best practice in dysphagia management in thrombolysed patients increased from 67% to 96% in the thrombolysed patient groups.

Conclusion: The outcomes suggest that a clinical protocol for dysphagia management in thrombolysed patients has the potential to improve service outcomes, reduce complications from dysphagia, have financial benefits for the hospital and increase service compliance. Furthermore, the results lend support for speech pathology services to manage dysphagia on weekends.

Keywordsstroke; dysphagia; protocol; thrombolysis
Year2017
JournalInternational Journal of Speech-Language Pathology
Journal citation19 (6), pp. 551-561
PublisherTaylor & Francis
ISSN1754-9515
Digital Object Identifier (DOI)https://doi.org/10.1080/17549507.2016.1221457
Scopus EID2-s2.0-84989236025
Research or scholarlyResearch
Page range551-561
Publisher's version
License
All rights reserved
File Access Level
Controlled
Output statusPublished
Publication dates
Online29 Sep 2016
Publication process dates
Accepted29 Jul 2016
Deposited17 Aug 2022
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