Post-stroke dysphagia: An exploration of initial identification and management performed by nurses and doctors
South African Journal of Communication Disorders
| Field | Value | |
| Title | Post-stroke dysphagia: An exploration of initial identification and management performed by nurses and doctors | |
| Creator | Pierpoint, Maggie Pillay, Mershen | |
| Description | Background: South African speech-language therapists are the only health professionals charged with dysphagia rehabilitation. However, registered nurses and doctors are often initial healthcare contact points for post-stroke dysphagia. Notwithstanding service concerns, they do indeed identify and manage post-stroke dysphagia. However, little is known about specifically what they do during these initial clinical encounters.Objective: To explore how doctors and registered nurses, on initial clinical contact, identify and manage post-stroke dysphagia.Method: A quantitative descriptive survey design, with non-probability, purposive sampling, was used. Twenty-one registered nurses and four doctors at a private South African hospital self-administered a questionnaire. Univariate analyses were completed by calculating frequency distributions of nurses’ and doctors’ identification and management practices.Results: Most (86%) did not use a formal screening tool. Indicators screened informally included: presence of drooling (84%) or gag reflex (76%), level of alertness (80%) and spontaneous saliva swallow (80%). Participants neglected important indicators like voluntary cough and vocal quality. Management provided included head of bed elevation (96%), speech-language therapist referrals (92%), nasogastric tube insertions (88%), intravenous fluids (84%) and positional adjustments (76%). Alternative management included total parenteral nutrition (52%), syringe feeding (48%), swallow muscle strengthening exercises (56%) and swallow manoeuvres (52%).Conclusion: Results indicated that doctors and registered nurses under-utilised important dysphagia indicators and used potentially harmful management practices like syringe feeding. Management practices further included out-of-scope methods like dysphagia rehabilitation exercises or manoeuvres. Recommendations include peer dysphagia screening training using formal tools and basic dysphagia management methods to better equip doctors and registered nurses when they clinically engage post-stroke patients. | |
| Publisher | AOSIS | |
| Date | 2020-05-28 | |
| Identifier | 10.4102/sajcd.v67i1.625 | |
| Source | South African Journal of Communication Disorders; Vol 67, No 1 (2020); 13 pages 2225-4765 0379-8046 | |
| Language | eng | |
| Relation |
The following web links (URLs) may trigger a file download or direct you to an alternative webpage to gain access to a publication file format of the published article:
https://sajcd.org.za/index.php/sajcd/article/view/625/1293
https://sajcd.org.za/index.php/sajcd/article/view/625/1292
https://sajcd.org.za/index.php/sajcd/article/view/625/1294
https://sajcd.org.za/index.php/sajcd/article/view/625/1291
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