Experiences of dysphagia trained nurses in the screening and early management of swallowing in acute stroke: A qualitative study

Abstract

BACKGROUND: Nurses often carry out swallow screening when patients are admitted to hospital following a stroke, some receive further training to conduct more comprehensive tests. Little is known about how they perceive their role. The aim of this study was to understand the experiences of Dysphagia Trained Nurses (DTNs) in acute stroke who conduct the comprehensive tests. METHODS: Nine DTNs were recruited from one UK hospital. They were identified by maximum variation and convenience sampling ensuring a broad demographic. Semi-structured interviews were carried out during usual shift patterns, in a quiet room on the acute stroke unit by a research and clinical SLT. Thematic analysis was conducted by two researchers and a summary of themes was verified by the participants. RESULTS: Four main themes were identified relating to the role, screening tool, training and pathway. The role was highly regarded, bringing professional benefits such as job satisfaction and career development. Nurses also identified that it was an essential role in acute stroke for the health and wellbeing of patients. The tool was easy to use but needed adaptations at times and the pathway was difficult to adhere to during busy periods when the use of the test with certain patients was questioned. Training and support was deemed crucial for the role and confidence developed with experience. CONCLUSIONS: Dysphagia Trained Nurses who conduct comprehensive dysphagia screening tests in acute stroke value the role. Further research is needed to quantify the impact that the nurses have on patient outcomes and stroke pathways.