Comparison of two approaches to screen for dysphagia among acute ischemic stroke patients

Nursing admission screening tool versus National Institutes of Health Stroke Scale

Dawn Bravata, Virginia S. Daggett, Heather Woodward-Hagg, Teresa Damush, Laurie Plue, Scott Russell, George Allen, Linda Williams, Jaroslaw Harezlak, Neale R. Chumbler

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

This study assessed the positive and negative predictive values and the sensitivity and specificity of a nursing dysphagia screening tool and the National Institutes of Health Stroke Scale (NIHSS) for the identification of dysphagia for veterans hospitalized with ischemic stroke. A secondary objective of this study was to evaluate the speech-language pathology consult rate before and after the nursing admission dysphagia screening tool. This retrospective cohort study evaluated veterans admitted to one Department of Veterans Affairs medical center with ischemic stroke during the 6 months both before and after the implementation of a nursing dysphagia screening tool, which was part of the admission nursing template. Stroke severity was measured with the use of the retrospective NIHSS. Dysphagia diagnosis was based on speech-language pathology evaluations. Dysphagia was present in 38 of 101 patients (38%) with ischemic stroke. The nursing dysphagia screening tool had a positive predictive value of 50% and a negative predictive value of 68%, with a sensitivity of 29% and specificity of 84%. The use of the NIHSS to identify dysphagia risk had a positive predictive value of 60% and a negative predictive value of 84%. The NIHSS had better test characteristics in predicting dysphagia than the nursing dysphagia screening tool. Future research should evaluate the use of the NIHSS as a screening tool for dysphagia.

Original languageEnglish
Pages (from-to)1127-1133
Number of pages7
JournalJournal of Rehabilitation Research and Development
Volume46
Issue number9
DOIs
StatePublished - 2009

Fingerprint

Patient Admission
National Institutes of Health (U.S.)
Deglutition Disorders
Nursing
Stroke
Veterans
Speech-Language Pathology
Sensitivity and Specificity
Cohort Studies
Retrospective Studies

Keywords

  • Aspiration risk
  • Dysphagia screening
  • Ischemic stroke
  • NIH Stroke Scale
  • Nursing admission
  • Pneumonia prevention
  • Predictive value of tests
  • Sensitivity and specificity
  • Stroke swallowing assessment

ASJC Scopus subject areas

  • Rehabilitation

Cite this

Comparison of two approaches to screen for dysphagia among acute ischemic stroke patients : Nursing admission screening tool versus National Institutes of Health Stroke Scale. / Bravata, Dawn; Daggett, Virginia S.; Woodward-Hagg, Heather; Damush, Teresa; Plue, Laurie; Russell, Scott; Allen, George; Williams, Linda; Harezlak, Jaroslaw; Chumbler, Neale R.

In: Journal of Rehabilitation Research and Development, Vol. 46, No. 9, 2009, p. 1127-1133.

Research output: Contribution to journalArticle

@article{c36222eeaf294a1eba19affa42adde70,
title = "Comparison of two approaches to screen for dysphagia among acute ischemic stroke patients: Nursing admission screening tool versus National Institutes of Health Stroke Scale",
abstract = "This study assessed the positive and negative predictive values and the sensitivity and specificity of a nursing dysphagia screening tool and the National Institutes of Health Stroke Scale (NIHSS) for the identification of dysphagia for veterans hospitalized with ischemic stroke. A secondary objective of this study was to evaluate the speech-language pathology consult rate before and after the nursing admission dysphagia screening tool. This retrospective cohort study evaluated veterans admitted to one Department of Veterans Affairs medical center with ischemic stroke during the 6 months both before and after the implementation of a nursing dysphagia screening tool, which was part of the admission nursing template. Stroke severity was measured with the use of the retrospective NIHSS. Dysphagia diagnosis was based on speech-language pathology evaluations. Dysphagia was present in 38 of 101 patients (38{\%}) with ischemic stroke. The nursing dysphagia screening tool had a positive predictive value of 50{\%} and a negative predictive value of 68{\%}, with a sensitivity of 29{\%} and specificity of 84{\%}. The use of the NIHSS to identify dysphagia risk had a positive predictive value of 60{\%} and a negative predictive value of 84{\%}. The NIHSS had better test characteristics in predicting dysphagia than the nursing dysphagia screening tool. Future research should evaluate the use of the NIHSS as a screening tool for dysphagia.",
keywords = "Aspiration risk, Dysphagia screening, Ischemic stroke, NIH Stroke Scale, Nursing admission, Pneumonia prevention, Predictive value of tests, Sensitivity and specificity, Stroke swallowing assessment",
author = "Dawn Bravata and Daggett, {Virginia S.} and Heather Woodward-Hagg and Teresa Damush and Laurie Plue and Scott Russell and George Allen and Linda Williams and Jaroslaw Harezlak and Chumbler, {Neale R.}",
year = "2009",
doi = "10.1682/JRRD.2008.12.0169",
language = "English",
volume = "46",
pages = "1127--1133",
journal = "Journal of rehabilitation R&D",
issn = "0748-7711",
publisher = "Rehabilitation Research and Development Service",
number = "9",

}

TY - JOUR

T1 - Comparison of two approaches to screen for dysphagia among acute ischemic stroke patients

T2 - Nursing admission screening tool versus National Institutes of Health Stroke Scale

AU - Bravata, Dawn

AU - Daggett, Virginia S.

AU - Woodward-Hagg, Heather

AU - Damush, Teresa

AU - Plue, Laurie

AU - Russell, Scott

AU - Allen, George

AU - Williams, Linda

AU - Harezlak, Jaroslaw

AU - Chumbler, Neale R.

PY - 2009

Y1 - 2009

N2 - This study assessed the positive and negative predictive values and the sensitivity and specificity of a nursing dysphagia screening tool and the National Institutes of Health Stroke Scale (NIHSS) for the identification of dysphagia for veterans hospitalized with ischemic stroke. A secondary objective of this study was to evaluate the speech-language pathology consult rate before and after the nursing admission dysphagia screening tool. This retrospective cohort study evaluated veterans admitted to one Department of Veterans Affairs medical center with ischemic stroke during the 6 months both before and after the implementation of a nursing dysphagia screening tool, which was part of the admission nursing template. Stroke severity was measured with the use of the retrospective NIHSS. Dysphagia diagnosis was based on speech-language pathology evaluations. Dysphagia was present in 38 of 101 patients (38%) with ischemic stroke. The nursing dysphagia screening tool had a positive predictive value of 50% and a negative predictive value of 68%, with a sensitivity of 29% and specificity of 84%. The use of the NIHSS to identify dysphagia risk had a positive predictive value of 60% and a negative predictive value of 84%. The NIHSS had better test characteristics in predicting dysphagia than the nursing dysphagia screening tool. Future research should evaluate the use of the NIHSS as a screening tool for dysphagia.

AB - This study assessed the positive and negative predictive values and the sensitivity and specificity of a nursing dysphagia screening tool and the National Institutes of Health Stroke Scale (NIHSS) for the identification of dysphagia for veterans hospitalized with ischemic stroke. A secondary objective of this study was to evaluate the speech-language pathology consult rate before and after the nursing admission dysphagia screening tool. This retrospective cohort study evaluated veterans admitted to one Department of Veterans Affairs medical center with ischemic stroke during the 6 months both before and after the implementation of a nursing dysphagia screening tool, which was part of the admission nursing template. Stroke severity was measured with the use of the retrospective NIHSS. Dysphagia diagnosis was based on speech-language pathology evaluations. Dysphagia was present in 38 of 101 patients (38%) with ischemic stroke. The nursing dysphagia screening tool had a positive predictive value of 50% and a negative predictive value of 68%, with a sensitivity of 29% and specificity of 84%. The use of the NIHSS to identify dysphagia risk had a positive predictive value of 60% and a negative predictive value of 84%. The NIHSS had better test characteristics in predicting dysphagia than the nursing dysphagia screening tool. Future research should evaluate the use of the NIHSS as a screening tool for dysphagia.

KW - Aspiration risk

KW - Dysphagia screening

KW - Ischemic stroke

KW - NIH Stroke Scale

KW - Nursing admission

KW - Pneumonia prevention

KW - Predictive value of tests

KW - Sensitivity and specificity

KW - Stroke swallowing assessment

UR - http://www.scopus.com/inward/record.url?scp=77249099274&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77249099274&partnerID=8YFLogxK

U2 - 10.1682/JRRD.2008.12.0169

DO - 10.1682/JRRD.2008.12.0169

M3 - Article

VL - 46

SP - 1127

EP - 1133

JO - Journal of rehabilitation R&D

JF - Journal of rehabilitation R&D

SN - 0748-7711

IS - 9

ER -