Date Available

3-17-2014

Year of Publication

2010

Degree Name

Doctor of Nursing Practice

Advisor

Dr. Marcia Stanhope

Committee Member

Dr. Debra Hampton

Co-Director of Graduate Studies

Dr. Linda Quinn Everett

Abstract

Stroke patients initially experience dysphagia approximately 42 - 67% of the time with noted improvement reducing rates to approximately 43% at seven days post-acute event (Perry & Love, 2001). The dysphagia experienced by these patients makes them at high risk to develop aspiration pneumonia. Overall, the financial impact of reducing aspiration pneumonia reduces the national cost of morbidity, mortality, and disability burden in this population. There is no generally recognized swallow screen. Program evaluation objectives were to establish a valid, reliable, cost effective, and easy to administer evidence RN bedside swallow screen for dysphagia to keep acute stroke patients safe from aspiration pneumonia as well as to develop confidence in the RN staff for this new skill and protocol through appropriate education materials and methods. Overall project objectives were to change organizational practice throughout the hospital to provide the stroke/TIA patients with a valid, reliable swallow screen. The practice change positively impacted organizational adherence to evidence-based clinical practice guidelines. This program evaluation includes lessons learned related to the politics involved in forging organizational practice change.

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