Proposed Topic (Most preferred): :
Clinical Safety and Quality Service III (Projects aiming at quality service to patients and their carers)
Proposed Topic (Second preferred): :
Clinical Safety and Quality Service I (Projects aiming to improve efficiency and effectiveness of care delivery to meet international standards)
Authors (including presenting author) :
Yeung KO(1), Chung MT(1), Lee WY(1), Chan YS(1), Choi NS(2), Ngan YH(2), Mok YN(1)
Affiliation :
(1)Department of Medicine, Pamela Youde Nethersole Eastern Hospital, (2)Department of Speech therapy, Pamela Youde Nethersole Eastern Hospital
Introduction :
More than 50% of stroke patients suffered from dysphagia have aspiration risk which affects their recovery and quality of life (Xu et al., 2019). It is beneficial for nurse involvement to enhance hospitalized acute stroke patients’ compliance in performing swallowing and oral-motor exercises taught by speech therapists (ST).
Objectives :
To study the effectiveness of nursing engagement on swallowing and oral-motor exercises to acute stroke patients with dysphagia on reducing the risk of aspiration pneumonia and improving swallowing function.
Methodology :
A prospective cohort and quasi-experimental study were undertaken in ASU from Dec 2022 to Apr 2023. 19 interventions and 20 control subjects were recruited. The control group received usual care. No swallowing or oral-motor exercises were implemented to patients by ST after assessment. Interventional group were referred to ST for providing tailor-made swallowing and oral-motor exercises. Candidates could review their exercises by using HA Go application. The progress was facilitated by nurses and supported by ST. The data of daily practice compliance, level of diet and fluid thickness, dysphagia severity and chest radiograph (CXR) results were collected and analyzed by Microsoft Excel.
Result & Outcome :
The compliance rate on performing swallowing and oral-motor exercises for the intervention group was 100%. At post-discharge 2-week phone follow-up, the compliance rate for the intervention group dropped to 71.4%. The comparison of control and intervention groups for diet level upgraded rate was 35% (7 out of 20) and 68.4% (13 out of 19) respectively; fluid thickness level improved rate was 25 % (5 out of 20) and 63.2% (12 out of 19) respectively. There was no remarkable change in the severity of dysphagia and CXR results of both groups. Moreover, a secondary outcome derived was the rapport building between patients and relatives during performing exercises.
This study had shown effectiveness with nurse involvement in compliance of performing swallowing and oral-motor exercises, post-stroke dysphagia improvement and positive secondary effects.
