Background/Aims To improve adherence to clinical stroke standards and provide equity in care delivered after-hours. Dysphagia screening is a simple, cost effective and integral component of acute stroke management and has a clinical and psychosocial impact on stroke recovery. Despite this, patients admitted out of hours are less likely to receive appropriate dysphagia screening resulting in unnecessary fasting or unsafe oral intake. Inadequate food and fluid management is linked to higher rates of aspiration pneumonia, longer length of hospital stay,1 and decreased Functional Independent Measurement (FIM) scores. The Stroke Foundation recommends that all patients should have a validated dysphagia screen completed within four hours of presentation to hospital and before any intake of food or fluids, including medications. 2
Methods We piloted having a stroke nurse coordinator attend after hour’s stroke calls to complete the screen and recorded non-adherence and contributing factors.
Results Our data showed a direct correlation between the presence of a stroke trained nurse and increased dysphagia screening. Before (Jan –May 2024) 21.40 % of stroke patients did not receive any swallowing screen prior to oral intake, this has dropped to 6.9% with a stroke nurse attending after hours.
Conclusion We reinforced how nurses improve adherence to clinical standards, noting a concurrent improvement in other acute stroke care indictors such as time to scanner and overall direct admission rates to stroke unit, suggests that having a stroke nursing role available out of normal working hours would have a direct impact on acute stroke clinical care standards.