Comparative analysis of two swallow screening tools
Review TypeNone: Degree-based Submission
Repository Posting Date2020-07-22T19:11:53Z
Author(s)Miller, Dina M.
Author DetailsDina M. Miller, FNP-BC, MSN, SCRN, RN, DNP-Student
Lead Author Sigma AffliationNon-member
TypeDNP Capstone Project
Level of EvidenceObservational
Research ApproachTranslational Research/Evidence-based Practice
KeywordsYale Swallow Protocol; Ischemic Stroke; Swallow Screening; Dysphagia Screening; Competency; Screening Tool; Swallow Screening Tool
Background: Dysphagia after stroke is common and is associated with an increased risk of aspiration, dehydration, and malnutrition. Early identification can allow for interventions to reduce complications.
Aim: This study evaluated the sensitivity and specificity of a modified Yale Swallow Protocol compared to a hospital developed bedside swallow screening tool.
Methods: Retrospective matched case-control method was used to collect data and compare two different bedside swallow screening tools. Comparison was made with evaluations completed by a Speech Language Pathologist. Electronic health records (EHRs) were reviewed from a 90-day period using hospital developed swallow screening tool and a 90-day period using the modified Yale Swallow Protocol.
Reviews included: ischemic stroke diagnosis; identification of bedside swallow screening tool used; SLP evaluation; gender; and age. Hospital developed swallow screening tool group included 169 patients. The modified Yale Swallow Protocol group included 192 patients.
Results: 2018 diagnostic survey comparison against SLP yielded the following: Sensitivity (79.2%), specificity (85.7%), PPV (75%), NPV (88.4%), and diagnostic accuracy (83.4%). 2019 diagnostic survey comparison against SLP yielded the following: Sensitivity (56.1%), specificity (89.1%), PPV (76.2%), NPV (76.6%), and diagnostic accuracy (76.5%).
Conclusions: Hospital developed bedside swallow screen was more sensitive to possible dysphagia while the modified Yale Swallow Protocol was slightly more specific. Both swallow screening tools perform equally well. This project was unable to identify a superior bedside swallow screening tool. The research illustrates the need for comprehensive training and competency validation of nursing staff.
Degree GrantorKing University
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