A survey of dysphagia screening practices across England and Wales.

Screening of acute stroke patients for signs of dysphagia (swallowing impairment) is recommended within 24 hours of hospitalization owing to increased risk of morbidity and mortality Speech and language therapists (SLTs) are the lead health professionals responsible for assessment of dysphagia. However, increasing demand for assessment and the relative dearth of SLTs in the NHS has resulted in delays in assessment of up to 6 days. Subsequently there is a drive for nurses to perform this screening process using a validated screening method and tool. This paper centres on the exploratory phase of a three-stage programme of research, designed to develop and evaluate a bedside dysphagia screening tool for use by registered nurses. Here the authors focus on a review of the salient professional literature and the findings of a survey of current dysphagia screening practices employed by nurses across 52 NHS trusts in England and Wales. The literature review revealed a lack of consensus on the requisite construct of a dysphagia screening tool and on criteria for determining signs of swallowing difficulties and their complications. These reported findings were echoed in the survey which highlighted wide variation in screening practices and use of screening criteria based on limited or no research-based evidence. The authors describe how this initial work has acted as a springboard for the design and evaluation of a screening tool for use by nurses at the patient's bedside, which employs a minimal combination of evidence-based criteria. [ABSTRACT FROM AUTHOR]