Decreasing Inappropriate Speech Consults in a Neurologic Intensive Care Unit

Abstract

Stroke-associated pneumonia (SAP) is a common post-stroke complication associated with an increased risk of hospital mortality, prolonged hospital stay, and associated healthcare costs. Nurses use bedside swallow screenings to help identify patients who require a formal swallow evaluation to address dysphagia and aspiration risk. There is evidence that implementing dysphagia screening early and following up with a specialist may reduce the risk of SAP. The purpose of this DNP project was to adjust the nursing bedside swallow screening algorithm to decrease inappropriate speech consults and allow speech therapists to triage patients that will benefit most from their services. To accomplish this goal, a trial protocol was created that instructs nursing to call a provider instead of speech therapy for further recommendations if the patient is too lethargic to participate in the nurses’ swallow screening. One hundred forty-nine patients admitted to the neurologic intensive care unit of the project site with a stroke diagnosis had swallow screenings reviewed for adherence to the new protocol. This project's results helped create a new swallow screening protocol to improve the process for patients, nurses, and speech therapists at the project site.