Development of Nursing Guidelines for Assessing Dysphagia in Elders with Stroke

Abstract

Dysphagia in stroke patients causes aspiration pneumonia which extends hospital stays and increases medical care costs. The objective of this research and development was to create nursing guidelines for assessing dysphagia in elders with stroke. The 54 participants were comprised of 10 nurses who developed the guidelines, 10 nurses who used the guidelines, and 34 patients with stroke who received care based on the guidelines. The research instrument consisted of personal data questionnaires, a questionnaire on feasibility and patient outcomes in using the guidelines, and a questionnaire on nurses' opinions on the guidelines. The guideline development was performed following four steps: 1) define the problem, 2) search for empirical evidence, 3) trial the guidelines, and 4) present the results. Data were analyzed using descriptive statistics and content analysis.

The research results revealed the nursing guidelines for assessing dysphagia in elders with stroke comprised four steps: 1) nursing care for patients at the first admission, 2) solid-diet swallowing test, 3) semisolid-diet swallowing test, and 4) liquid-diet swallowing test. The guidelines were reliable quality using AGREE II and the value was 84.23%. All nurses who used the guidelines agreed that the developed guidelines were feasible for assessing dysphagia in elder patients and were easy to understand and implement. The average satisfaction score with the guidelines was at level 3 (strongly agree). No incidence of aspiration was found during evaluation.

This guideline could prevent aspiration for elder patients with stroke, which is one cause of pneumonia while patients are staying in a hospital.