Performing Dysphagia Screening Tests - Research Proposal Example

Capstone Project Dysphagia is a condition where patients experience difficulty in swallowing, mainly due to an infection of throat tissues. Performing dysphagia screening tests on stroke patients have been used as a precautionary measure to save the lives of many patients (Edmiaston, 2010). The problem identified here is that most stroke patients have swallowing problems due to their neurological condition. (Blitzer, 2011) Failure to administercase, allowingg test, in thiscase, ‘‘dysphagiatest hee dangersoses the patients to dangers of check inspiration which cancheckk them. It is the mandate of all nurses who deals with such patients to ensure that their safety if prioritized. This proposal seeks to address this issue by making sure that it is mandatory for all practicing nurses who deal with such patients of stroke, to administer dysphagia tests immediately a patient is admitted in the hospital before giving them any food substances. For this project, I will use an evidence based model. For effective results, in this research, I have used the conduct and utilization of research in nursing model (CURN) since the model seeks to carry out a research which gives findings to s particular behavior which improves the patients’ health outcome. (Scmidt, 2014)Similarly, conducted over a period of two weeks, this research seeks to prove that Dysphagia screening saves lives of persons who suffer from stroke on admission to hospitals. 1. A description of the problem. Many stroke patients need critical attention. Ensuring their safety while they have been admitted is one of the nurses’ most important things. The manner in which stroke patients are handled on arriving at the hospitals needs to be addressed. Most of the nurses do not carry out dysphagia screening as recommended for all stroke patients in the AHA/ASA guidelines (Stephenie, 2013). Some nurses go to the point of giving these patient foods without having the swallowing tests done on them prior to this. According to the data collected from my experience, only 3 out of 4 patients go through the swallowing tests. This means that the safety of the remaining patients is not prioritized. For the reason that nurses fail to carry out this necessary test, an estimated 50,000 die every year due to aspiration pneumonia after stroke. Evidently, most of these deaths can therefore be avoided by carrying out this test. The problems with swallowing in these patients are associated with a higher mortality rate (Jeff, 2013). Moreover, technologies have evolved which enable the patients to be screened for dysphagia abnormalities over a short period and have accurate results. Failure to carry out such tests, therefore is due to ignorance by some nurses. To avoid these problems, in the view of patients’ safety being upheld, it is very important that these tests be declared mandatory for all patients suffering from stroke who are admitted to the emergency rooms. Nurses who fail to screen patients prior to giving them oral feeds should also be subjected to disciplinary actions in case patients die of throat complications. Resolution Strategy The medical field is one of the most critical fields. For this type of a change to take effect, there are several plans that should be employed. In my view, there are various ways in which this approach where stroke patients can be screened for swallowing problems. The resolution is to make sure that all the nurses who are practicing in a field where they deal with stroke patients must and should carry out the screening. Through such approaches as this, the mortality rate will be lowered. In order to effectively apply this strategy, there should be a formative evaluation. Here, issues such as existing policies and model policies are developed, administrative structures should be updated, staffing for the administration works. Monitoring and enforcement systems should also be devised. Material resources should also put into play since all the process requires capital investment. Prioritization of this problem and reviewing of all evidence related to dysphagia is equally important. Since this resolution advocates for change, it is also important to engage policy makers to come up with the best policies regarding the field. Implementation strategy The implementation of this work lies in the hands of many players. However, the most affected are the nurses who deal with the patients when they are admitted to hospitals with stroke complications. The nurses should first of all be imparted with the knowledge regarding the importance of swallowing dysfunctions screening. Most nurses ignore this important procedure hence endangering the lives of their patients. When this proposal is being implemented, the nurses must be advised on the lifesaving importance of this procedure. The hospitals and the institutions of health care where the patients are cared for must also, for the assurance that the patients will be taken care of, include such a provision as that all stroke patients who are admitted to their institutions have to undergo the swallowing screening test as a mandatory requirement. Nurses who fail to observe such rules should be subject to questioning whether the patients develop complications or not. Thirdly, for the strategy to be effective, the hospitals should ensure that they acquire the most recent dysphagia screening equipment’s. Even at this point, the safety of the patients should be prioritized, some equipments, though effective have their side effects. Without the proper screening equipment, screening will not be effective and the result is that patients will be wrongly diagnosed. This may lead to death or further complications and since technologies have emerged on screening for dysphagia, hospitals should consider acquiring the best. Finally, for the resolution strategy to be properly implemented, there must be proper follow up, it is therefore necessary for the health facilities to allocate swallowing screening specialists in order to oversee the process of screening of all patients. Basically, an implementation should follow these steps. Proposed Evaluation of Outcomes The application of such a resolution as to make it mandatory that all patients who are diagnosed with stroke to go through a dysphagia screening test is of central essence. (Lakshminarayan, 2010) The evaluation of the effectiveness of the project should be done after the strategy have been implemented as proposed. There should be a systematic way of evaluating the effectiveness of the strategy. The best means is to compare past and present data on the number of stroke patients who die when they are in the emergency rooms. The evaluation can as well be conducted using two groups of patients, those who have gone through the dysphagia screening and those who have not then comparing their performance. Through such comparison, the effectiveness of the screening tests can be accurately ascertained. The evaluation should also include the mortality rate of the stroke patients before and after the adoption of the mandatory medical nursing practice. The data collected should then be analyzed with the patient’s safety in mind. At this point, it is advisable that the physicians evaluating to also use direct observation approach since the patients are in the hospital full time. Thus they can easily evaluate their progress via observation. The evaluation should also include all the unintended consequences and also find out whether these screening methods used are cost effective. Dissemination of Findings Method These findings will be important for all the nurses practicing in this field. At this point, dissemination is taken to mean a process which is planned that involves the consideration of audiences who are concerned and the setting in which findings on the research are to be received and where the findings are found appropriate, they interact with broader policies and audiences in the health service in ways that facilitate the uptake of research in processes of decision making and practice. (Wilson, 2010) In this research proposal, the method used to disseminate the findings can be through polishing the results and findings in the different medical journals in the country. The strategy is to ensure that the findings are presented in a manner that is eye catching and one that is clear, concise and complete. Presenting the same findings to policy makers is also a thing of central importance. If these findings are employed by policy makers, the practice will be mandatory in the whole nation which may be adopted in other medical institutions in the world. Adoption would see the world cases of deaths of stroke patients reduce significantly. At the dissemination of this information, the clinical guidelines pertaining to the dissemination of clinical information findings are going to be followed to the letter. The dissemination of the research findings requires much time and changing the nurse’s behaviors of non-observation is also somewhat a challenge. For this information to be effectively disseminated effectively, all nurses should be made to know and understand the importance of this practice. Secondly, to disseminate these research findings, there should be professional interventions, financial interventions where we can have professional incentives for all the nurses who effectively employ all the guidelines of swallowing screening. Regulatory interventions can also be used to disseminate. Here, there is employment of medical auditors and feedback to ensure that all nurses adhere to all such requirements. Besides all these, most importantly, there should be reminders interventions where patients are reminded from time to time about the practice. References Blitzer, A. ,. (2011). Clinical Evaluation . In Neurological Disorders oof the Larynx. Chicago: Thieme . (pp. 255-257) Edmiaston, C. L. (2010). VAlidation of a dysphagia screening in acute stroke patients. American Journal of Critical Care, 357-364. Jeff, E. M.-S.-S. (2013). Validation of a Dysphagia Screening Tool in Acute Stroke Patients. St Louis. Lakshminarayan, T. .. (2010). Utility of Dysphagia Screening Results in Predicting Post Stroke Pneumonia. In Stroke (pp. 2849-2854). Scmidt, B. (2014). Evidence Based Practice For Nurses . New York: Jones and Barlette. Stephenie, A. A. (2013, February 21). Implementation of Stroke Dysphagia Screening in the Emergency Department. Retrieved from US National Library of Medicine. National Institutes of Health: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3595673 Wilson, P. m. (2010). Disseminating research findings: what should researchers do? A systematic scoping review of conceptual frameworks. Medical Health Journal. Read More