Conference Proceedings | J Oral Health Dent. 2018;1(S2):A021 | Open Access
Methodologies to Explore How Variation in Assessment and Clinical Management of Dysphagia in Acute Stroke Affects Development of Stroke Associated Pneumonia (SAP)
Eltringham SA1,2, Bray B3, Smith C4, Kilner K2, Pownall S1 and Sage K2
1Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
2Sheffield Hallam University, Sheffield, UK
3Royal College of Physicians, London, UK
4University of Manchester, Manchester, UK
Purpose: This Stroke Association-funded study will investigate how variations in dysphagia assessment and management during the first 72 hours post admission impact on development of stroke-associated pneumonia.
Method: Phases 1 and 2 of this mixed methods study involve the development of a national survey, which will include a systematized review of the literature, a review of medical records, and interviews with patients and staff. Data will be triangulated to inform a survey about dysphagia screening and management in hospitals registered with Sentinel Stroke National Audit Programme (SSNAP). Results from the survey will be cross-referenced with the SSNAP register and odds of developing SAP will be estimated, using multiple variable logistic regression analysis.
Results: The systematized review will summarize current evidence on methods of assessment and organizational factors that affect the risk of SAP. The case note review will provide detailed understanding of dysphagia management during the first 72 hours from admission. Fifteen national interviews with staff and 5 patient interviews will provide insights into current practice not available from quantitative data. Statistical analysis of the survey responses with the SSNAP data will bring together this information to highlight the barriers and facilitators for reducing risk of SAP.
Conclusion: Potential clinical implications and relevance to the research community include increased awareness of potential risk factors of SAP, insights into the application of mixed methods to answer a clinical research question and large data registries to reveal variations in practice and patient outcomes.