What is being done?

A screening tool used in Derriford Hospital is helping staff to identify those at risk of swallowing difficulties, enabling them to give advice and strategies for improving swallowing and when to refer for specialist assessment.

A swallowing screening tool has been developed, for registered nurses to undertake a first line assessment of swallowing risks of patients. The tool has been developed by a Speech and Language Therapist (SALT), a dietician and a nurse. This tool guides the registered nurse in the assessment and identification of risks of swallowing; gives advice and strategies for improving swallowing and guidance as to when to refer for medical advice or specialist assessment by SALT.

The swallowing screening tool prompts the use of various strategies for enabling a good swallow for patients who seem reluctant or unable to swallow. This allows oral fluid intake to be maintained safely as early as possible and for as long as possible; it avoids patients being Nil By Mouth when with a few strategies taken can enable them to be able to swallow safely.

The swallowing screening tool is being introduced by SALT providing ward-based training to registered nurses.

What is new and different?

• The tool is based on a similar tool developed for the assessment of patients on the Stroke unit with dysphagia, the swallowing screening tool allows an early assessment of swallowing risk and identification of first line care/treatment to enable safe swallowing.
• It allows the appropriate support and care of people who have dementia and are experiencing difficulties in swallowing, rather than simply keeping the patient Nil By Mouth and awaiting assessment by SALT.

What difference this seems to be making

The tool is raising the confidence of registered nurses in the assessment of swallowing risks in people with dementia.  The tool is currently only in pilot stage.

Plans for taking the project forward

Once pilot stage on Healthcare of Elderly wards has demonstrated that the tool is useful and reliable, the swallowing screening tool will be introduced to other areas.