Abstract 2284: Reliability and Validity of the MGHS Dysphagia Screening Tool for Stroke Patients
Background Dysphagia occurs in approximately 55% of acute stroke patients and is associated with aspiration pneumonia. Clinical practice guidelines recommend that all patients who are admitted with the diagnosis of stroke or suspected stroke should be screened for dysphagia utilizing a validated screening tool prior to receiving any food, fluid, or medication by mouth.
Purpose The purpose of the study is to determine the reliability and validity of the Marquette General Health Systems Dysphagia Screen for identifying patients at risk for aspiration.
Method This non-randomized study utilized a collaborative tracking tool that compared results of the Nursing Dysphagia Screen (NDS) to the Speech Language Pathologist Swallow Evaluation (SLPSE). Two Registered Nurses rated each patient utilizing the NDS and then the patient was rated on the SLPSE. The NDS includes10 items: and the Speech Language Pathologist portion of the tool consisted of 8 items.
Results One hundred subjects ranged in age from 20-94 (M=70.31, SD=14.6). There were more males (n=58) than females (n=42). The majority were admitted to the medical unit (64%), followed by cardiac (14%), ICU (12%) and CCU (10%). Length of stay ranged from 1-15 days (M=3.73, SD=2.8). NIH scores ranged from 0-20 (M=6.8, SD=7.4). Kappa was calculated to determine inter-rater reliability. For 63 pairs of ratings between two staff nurses, Kappa=.81 indicates strong reliability. Scores on the Nursing Dysphagia Screen were compared to 86 Speech Language Pathologist Swallow Evaluations. The Phi Coefficient was not significant indicating that the nurses’ and speech therapists ratings’ were similar. In addition, when there were differences it was false positives by nurses.
Conclusion The MGHS NDS is a quick screening tool used by nursing in an effort to prevent aspiration. Prior to implementing the use of the tool, it was important to establish the reliability and validity of the tool. Results indicate that there is strong inter-rater reliability. Validity was established given that there were no significant difference in ratings between the nurses and speech therapists. It appears that the MGHS NDS is an effective early screening tool for dysphagia.
- © 2012 by American Heart Association, Inc.