Screening swallowing function of patients with acute stroke. Part two: detailed evaluation of the tool used by nurses

Stroke is a common problem and a major consumer of health and social care budgets in the UK. Dysphagia is a frequent accompaniment and its management has the potential to exert significant influence within the rehabilitation process. This study explores in detail the performance of a screening tool (based on the Standardized Swallowing Assessment) used by nurses. Based on 68 complete screening episodes by independently competent nurses, with the effects of chance removed, the tool demonstrated good agreement with summative clinical judgement of swallow function (kappa = 0.88). The accuracy of results supported the full training and education programme for nurses. Not all components of the tool were required; analyses suggested elimination of three variables but further exploration is warranted. As a component of evidence-based guidelines for nutritional support in acute stroke, the screening initiative contributed to improved patient outcomes.