Triumphs and Challenges of Implementing a Nursing Bedside Swallow Screening Tool: A Stroke Coordinator's Perspective

2009 ◽  
Vol 18 (4) ◽  
pp. 129-133 ◽  
Author(s):  
Kelly Poskus
Keyword(s):  
Screening Tool ◽  
Hospital Setting ◽  
Swallow Screening

Abstract The bedside swallow screen has become an essential part of the evaluation of a patient after stroke in the hospital setting. Implementing this type of tool should be simple. However, reinforcement and monitoring of the tool presents a challenge. Verifying the consistency and reliability of nurses performing the bedside swallow screen can be a difficult task. This article will document the journey of implementing and maintaining a reliable and valid nursing bedside swallow screen.

scholarly journals Delirium screening anchored in child development: The Cornell Assessment for Pediatric Delirium

2014 ◽  
Vol 13 (4) ◽  
pp. 1005-1011 ◽  
Author(s):  
Gabrielle Silver ◽  
Julia Kearney ◽  
Chani Traube ◽  
Margaret Hertzig
Keyword(s):  
Child Development ◽  
Screening Tool ◽  
Hospital Setting ◽  
Lessons Learned ◽  
Hospitalized Children ◽  
Bedside Nurse ◽  
Symptom Domains ◽  
Anchor Points ◽  
Bedside Nursing ◽  
And Training

AbstractObjective:The recently validated Cornell Assessment for Pediatric Delirium (CAPD) is a new rapid bedside nursing screen for delirium in hospitalized children of all ages. The present manuscript provides a “developmental anchor points” reference chart, which helps ground clinicians' assessment of CAPD symptom domains in a developmental understanding of the presentation of delirium.Method:During the development of this CAPD screening tool, it became clear that clinicians need specific guidance and training to help them draw on their expertise in child development and pediatrics to improve the interpretative reliability of the tool and its accuracy in diagnosing delirium. The developmental anchor points chart was formulated and reviewed by a multidisciplinary panel of experts to evaluate content validity and include consideration of sick behaviors within a hospital setting.Results:The CAPD developmental anchor points for the key ages of newborn, 4 weeks, 6 weeks, 8 weeks, 28 weeks, 1 year, and 2 years served as the basis for training bedside nurses in scoring the CAPD for the validation trial and as a multifaceted bedside reference chart to be implemented within a clinical setting. In the current paper, we discuss the lessons learned during implementation, with particular emphasis on the importance of collaboration with the bedside nurse, the challenges of establishing a developmental baseline, and further questions about delirium diagnosis in children.Significance of Results:The CAPD with developmental anchor points provides a validated, structured, and developmentally informed approach to screening and assessment of delirium in children. With minimal training on the use of the tool, bedside nurses and other pediatric practitioners can reliably identify children at risk for delirium.

Preventing Aspiration Complications: Implementing a Swallow Screening Tool

2019 ◽  
Vol 73 (4_Supplement_1) ◽  
pp. 7311515363p1
Author(s):  
Gina Pifer ◽  
Janelle Hatlevig ◽  
Tina Wangen ◽  
Kirsten Vitale
Keyword(s):  
Screening Tool ◽  
Swallow Screening

Implementation of an Automated Sepsis Screening Tool in a Community Hospital Setting

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Penny B. Cooper ◽  
Bobbi J. Hughes ◽  
George M. Verghese ◽  
J. Scott Just ◽  
Amy J. Markham
Keyword(s):  
Screening Tool ◽  
Community Hospital ◽  
Hospital Setting ◽  
Sepsis Screening

scholarly journals TIME to think about delirium: improving detection and management on the acute medical unit

2018 ◽  
Vol 7 (3) ◽  
pp. e000200 ◽  
Author(s):  
Yehudit Bauernfreund ◽  
Matthew Butler ◽  
Sumathi Ragavan ◽  
Elizabeth L Sampson
Keyword(s):  
Screening Tool ◽  
Hospital Setting ◽  
Education Programme ◽  
Junior Doctors ◽  
Medical Unit ◽  
Acute Medical Unit ◽  
Increased Risk ◽  
National Guidance ◽  
Risk Of Falls ◽  
Personal Orientation

Delirium affects 18%–35% patients in the acute hospital setting, yet is often neither detected nor managed appropriately. It is associated with increased risk of falls, longer hospital stay and increased morbidity and mortality rates. It is a frightening and unpleasant experience for both patients and their families. We used quality improvement tools and a multicomponent intervention to promote detection and improve management of delirium on the acute medical unit (AMU). We reviewed whether a delirium screening tool (4AT) had been completed for all patients aged over 65 years admitted to the AMU over 1 week. If delirium was detected, we assessed whether investigation and management was adequate as per national guidance. After baseline data collection, we delivered focused sessions of delirium education for doctors and nursing staff, including training on use of the 4AT tool and the TIME (Triggers, Investigate, Manage, Engage) management bundle. We introduced TIME checklists, an online delirium order set and created a bedside orientation tool. We collected data following the interventions and identified areas for further improvement. Following our first PDSA (Plan, Do, Study, Act) cycle, use of the 4AT screening tool improved from 40% to 61%. Adequate assessment for the causes of and exacerbating factors for delirium increased from 73% to 94% of cases. Use of personal orientation tools improved from 0% to 38%. In summary, a targeted staff education programme and practical aids for the ward have improved the screening and management of delirium on the AMU. This may be improved further through more frequent training sessions to account for regular change-over of junior doctors and through implementing a nursing champion for delirium.

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