Article type
Abstract
Background: Post-extubation oropharyngeal dysphagia (PED) refers to signs and symptoms related to difficulty in swallowing efficiently and safely the inability to safely pass food from the mouth to the stomach.1 The prevalence of PED ranges from 3% to 62%.2, 3 It occurs in 41% of critically ill adults.4 The use of quick and inexpensive screening tools by nurses makes it possible to identify patients who are more likely to have dysphagia. Screening and early detection of PED by nurses in the ICU can reduce the adverse events associated with dysphagia, decrease the time patients spend without adequate nutrition and hydration, and improve clinical outcomes.5,6
Objectives: This study highlights the implementation of criteria for screening and early detection of PED in the Adult Intensive Care Unit (IACU) of the University Hospital of the University of São Paulo (HU USP), Brazil. (1) Raise awareness among nursing professionals and interdisciplinary teams (2) Identify areas and strategies for the sustainability of care. Methods: This project used the JBI 7-phase implementation framework to implement evidence in practice. We used the JBI Practical Application of Clinical Evidence System (PACES) and Getting Research into Practice (GRiP) tools to promote changes at the study site. We designed the project considering the main barriers and facilitators identified in the baseline audit with an educational program based on the best evidence for screening and detecting PED. We used changes in nursing documentation records to assess the compliance rates at the baseline and follow-up audits.
Results: Audits showed deficits in both current and best practices. We identified barriers and implemented appropriate strategies. The first audit showed an improvement in compliance with good practices. Of the seven criteria, five showed 100% compliance. The second follow-up audit revealed that compliance remained at 100.0% for five criteria and increased for the other two after intervention for poor results in documented nursing care.
Conclusions: The first follow-up audit showed good adherence to an educational program for the screening and detection of PED by nurses. In line with the new strategies, the second follow-up audit showed improvement in nursing documentation.
Objectives: This study highlights the implementation of criteria for screening and early detection of PED in the Adult Intensive Care Unit (IACU) of the University Hospital of the University of São Paulo (HU USP), Brazil. (1) Raise awareness among nursing professionals and interdisciplinary teams (2) Identify areas and strategies for the sustainability of care. Methods: This project used the JBI 7-phase implementation framework to implement evidence in practice. We used the JBI Practical Application of Clinical Evidence System (PACES) and Getting Research into Practice (GRiP) tools to promote changes at the study site. We designed the project considering the main barriers and facilitators identified in the baseline audit with an educational program based on the best evidence for screening and detecting PED. We used changes in nursing documentation records to assess the compliance rates at the baseline and follow-up audits.
Results: Audits showed deficits in both current and best practices. We identified barriers and implemented appropriate strategies. The first audit showed an improvement in compliance with good practices. Of the seven criteria, five showed 100% compliance. The second follow-up audit revealed that compliance remained at 100.0% for five criteria and increased for the other two after intervention for poor results in documented nursing care.
Conclusions: The first follow-up audit showed good adherence to an educational program for the screening and detection of PED by nurses. In line with the new strategies, the second follow-up audit showed improvement in nursing documentation.