Effect of Implementing Dysphagia Care Bundle on Functional Oral Intake and Stroke Associated Pneumonia among Critically Ill Stroke patients

Abstract

Background: dysphagia occurs post-stroke imposes a greater risk that can result in poor outcomes such as severe aspiration pneumonia, malnutrition, dehydration and prolonged ICU stay. So evidence-based interventions to prevent and manage is a necessity.Aims:To evaluate Effect of Implementing Dysphagia Care Bundle on Functional Oral Intake & Stroke Associated Pneumonia for the Severely Ill stroke patients. Design: A quasi-experimental design was utilized. Settings: The research was carried out at Neurointensive Care Unit at Tanta Main University Hospital affiliated to Ministry of Higher Education and Scientific Research. Subjects: Purposive samples of 60 critically ill adults’ patients, newly admitted with acute stroke were involved in the study.Tools: Six tools were employed to gather data. Tool (I): Demographic & Clinical data Sheet,Tool (II): "Early dysphagia screening tool" Gugging Swallowing Screen (GUSS), Tool (III): Functional Oral Intake Scale (FOIS),Tool (IV): Stroke- associated Pneumonia Score, Tool (V): Bedside Oral Exam (BOE) and the Barrow Oral Care Protocol (BOCP),Tool (VI): Modified Nutrition Risk Assessment in Critically Ill score (m NUTRIC).Results: results of the present research has shown that there were statistically meaningful improvement in levels of dysphagia and functional oral intake, Lower risk for Stroke associated pneumonia, malnutrition and Shorter duration of stay in the intensive care unit among patients in the study group after implementing intervention bundle in comparison with the control group (P<0.001).Conclusion: Dysphagia care bundle can significantly reduce dysphagia severity, improve functional oral intake and decrease risk of Stroke associated pneumonia among critically ill patients with acute stroke. Recommendations: Application of dysphagia care bundle as a part of treatment plan of critically ill stroke patients. Replication of the study on a larger probability sampling.