1. Appalachian Stroke Network Dysphagia Screening Update
Ruby Memorial Hospital
Primary Stroke Center
Morgantown, WV
Bruce McKee MS,CCC/SLP
Director, Rehabilitation Services

2. Ruby Memorial Hospital Primary Stroke Center
Current acute beds: 531
Dedicated Neuro beds
14 floor beds
12 step-down beds
8 Neuro ICU beds
Overflow to other units
2015: 978 Stroke Page Activations (81.5/mos)
January 2017 acute beds: 575

3. Nursing Standardized Swallow Assessment
Dysphagia screening for acute stroke and TIA patients that was published by Perry in 2001.
It is currently administered by RN’s who have completed a hands-on training course conducted by a Speech Pathologist.
There are two sections of the SSA. Part A involves observing the patient (is patient alert and responsive to speech, maintain an upright posture, follow oral motor commands, cough on command, breath freely, clear vocal quality). Not observed=FAIL
Part B involves presentation of water. RN observes for s/s aspiration. Cough, throat clear or wet vocal quality=FAIL
FAIL=Patient NPO, await S&S evaluation.
PASS=patient started on baseline diet. Will still be evaluated by S&S.

4. Our Performance JC Benchmark: 85.7% 2014: 74.5% 2015: 79.5%

5. Challenges Oral meds charted on intubated patients
Off-service/off-unit patients
Oral meds documented prior to screening
Hemorrhagic strokes, non-traumatic brain bleeds
Terminology Swallow Screening vs Speech & Swallow Evaluation

6. Strategies for Improvement
Dysphagia Sub-committee
Spotlight performance
Daily audits/ s
Monthly PI meetings
Personal feedback
s and counseling to staff
Real-time communication
Reminders
Ongoing Education
House-wide Nursing Aspiration Screening Tool