We have located links that may give you full text access.
Swallow management in patients on an acute stroke pathway: quality is cost effective.
Archives of Physical Medicine and Rehabilitation 1995 December
OBJECTIVE: To assess the effects of swallowing management in patients with acute nonhemorrhagic stroke placed on a clinical pathway, and to evaluate whether swallow function on admission can be used as a predictor of length of stay (LOS) and outcome disposition.
DESIGN: Intervention study to reduce complications of dysphagia in patients with acute stroke.
SETTING: Urban community hospital.
PATIENTS: Data were collected on 124 patients with acute nonhemorrhagic stroke admitted from January to December 1993.
INTERVENTIONS: A swallow screen was completed within one day of admission and before any oral intake.
MAIN OUTCOME MEASURES: Dysphagia and functional independence measure (FIM) scores on admission, occurrence of aspiration pneumonia, LOS, outcome disposition and cost effectiveness analysis.
RESULTS: Thirty-nine percent of all patients (p < .05) failed the initial swallow screen and required altered dietary texture and intervention. No patients developed aspiration pneumonia. Of those with dysphagia, 21% recovered intact swallowing by discharge; 19% required gastrostomy tube placement. Patients with dysphagia had lower admission FIM scores than nondysphagia patients. The LOS was longer for the dysphagia group (8.4 +/- 0.9 days) compared with patients without dysphagia (6.4 +/- 0.6 days, p < .05). Patients with dysphagia were less likely to be discharged to home (27%) than were nondysphagia patients (55%), and twice as likely to be discharged to a nursing home (p < .05).
CONCLUSIONS: This study demonstrates that early swallow screening and dysphagia management in patients with acute stroke reduces the risk of aspiration pneumonia, is cost effective, and assures quality care with optimal outcome.
DESIGN: Intervention study to reduce complications of dysphagia in patients with acute stroke.
SETTING: Urban community hospital.
PATIENTS: Data were collected on 124 patients with acute nonhemorrhagic stroke admitted from January to December 1993.
INTERVENTIONS: A swallow screen was completed within one day of admission and before any oral intake.
MAIN OUTCOME MEASURES: Dysphagia and functional independence measure (FIM) scores on admission, occurrence of aspiration pneumonia, LOS, outcome disposition and cost effectiveness analysis.
RESULTS: Thirty-nine percent of all patients (p < .05) failed the initial swallow screen and required altered dietary texture and intervention. No patients developed aspiration pneumonia. Of those with dysphagia, 21% recovered intact swallowing by discharge; 19% required gastrostomy tube placement. Patients with dysphagia had lower admission FIM scores than nondysphagia patients. The LOS was longer for the dysphagia group (8.4 +/- 0.9 days) compared with patients without dysphagia (6.4 +/- 0.6 days, p < .05). Patients with dysphagia were less likely to be discharged to home (27%) than were nondysphagia patients (55%), and twice as likely to be discharged to a nursing home (p < .05).
CONCLUSIONS: This study demonstrates that early swallow screening and dysphagia management in patients with acute stroke reduces the risk of aspiration pneumonia, is cost effective, and assures quality care with optimal outcome.
Full text links
Related Resources
Trending Papers
Challenges in Septic Shock: From New Hemodynamics to Blood Purification Therapies.Journal of Personalized Medicine 2024 Februrary 4
Molecular Targets of Novel Therapeutics for Diabetic Kidney Disease: A New Era of Nephroprotection.International Journal of Molecular Sciences 2024 April 4
The 'Ten Commandments' for the 2023 European Society of Cardiology guidelines for the management of endocarditis.European Heart Journal 2024 April 18
A Guide to the Use of Vasopressors and Inotropes for Patients in Shock.Journal of Intensive Care Medicine 2024 April 14
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app