Date of Conferral

2018

Degree

Doctor of Nursing Practice (DNP)

School

Nursing

Advisor

Barbara Niedz

Abstract

Dysphagia is a leading complication of a stroke. A nurse-driven bedside swallow screen can identify dysphagia and decrease the risk for complications such as aspiration pneumonia. At the project site, the use of the bedside swallow screen was at 33%; there was noncompliance with the use of the bedside swallow screen by the emergency department nurses. The purpose of the doctoral project was to increase the use of the bedside swallow screen. Published outcomes, research, and reports generated from archived data were the sources of evidence. The six sigma methodology was used to inform the quality improvement doctoral project. At the end of the quality improvement project, the posttest scores were statistically significantly higher than the pretest scores mean. The nurses' scores demonstrating level of confidence before the training (M = 68.39, SD = 10.86) were lower than scores indicating their level of confidence after the training (M = 79.55, SD = 10.56), and the paired t test showed statistical significance p < .001. The training made a statistically significant difference in the emergency department nurses' knowledge and confidence in performing the dysphagia screen. After the causes of low compliance were identified, strategies developed and implementation of the swallow screen in the emergency department increased. The quality improvement project improved the use of the dysphagia screen at the project site from 33% to 60%. The project made a positive impact on social change by reducing stroke patients' risk for complications.

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