The roll out of the ASSIST dysphagia screening tool for nursing in acute stroke care.

Abstract

The National Stroke Foundation's 'Clinical guidelines for stroke management' (2010) stipulate that patients should be screened for swallowing deficits (dysphagia) before oral intake, by specifically trained physicians. Presently, Speech Pathologists (SP) at Epworth Richmond (ER) assess the swallowing of stroke patients to determine safety for oral intake. However, this process can be somewhat ad hoc being dependant on timely referrals, and not extending to after hours or weekend periods. The ASSIST dysphagia screening tool developed by the Victorian Stroke Clinical Network (VSCN) is an evidence-based tool originally developed in NSW being endorsed by the Greater Metropolitan Clinical Task Force. Although not a formally validated tool, its development succeeded a thorough review of current evidence and is widely used across other acute stroke services. This quality initiative aimed to investigate the capacity for successful implementation of the ASSIST tool at ER, to comply with current evidence-based guidelines and to investigate potential barriers, to its use (eg. in a private hospital setting, with a number of different consultants).