Abstract NS1: Hands-On Curriculum Educates Neuroscience Nurses on Bedside Swallow Screening

Background: Swallow screening effectively identifies patients at risk for post-stroke dysphagia. This screening can be effectively performed by nurses at the bedside to aid in early detection. However, many screens lack curricula to adequately establish knowledge and skills. Purpose: The purpose of this project was to design and implement a comprehensive, interdisciplinary curriculum to promote a nurse-driven bedside swallow screen across the care continuum in our hospital. Methods: An interprofessional team of content experts developed and taught an eight-hour stroke curriculum, which included care of ischemic and hemorrhagic stroke, neurological assessment and diagnostics, stroke rehabilitation, and an introduction to the multidisciplinary care team. An interactive training session on a valid and reliable nurse-driven bedside swallow screen was included, featuring lecture, computer-based modules, and hands-on simulation components. Three validations of the swallow screen were completed by each bedside nurse to ensure competency, performed under the supervision of a speech pathologist or clinical nurse educator. The process included completion of the screen on a stroke patient and documentation on a newly created EMR flowsheet. Nursing knowledge and behavior were assessed by post-tests and on-unit validations of the swallow screen. Results: Evaluation based on Kirkpatrick’s Model found that nurses’ initial reaction was positive, describing the curriculum as engaging and empowering. After implementation, the percentage of swallow screens properly performed increased from 73.3% in 2015 to 93.5% in 2017 (p<.001). Screening effectiveness was reinforced with additional education on dysphagia by the neuroscience nursing unit-based councils after the project roll-out. The incidence of aspiration pneumonia and all pneumonia on the neurology unit decreased by over 25% after the implementation of this initiative. Conclusion: In conclusion, an innovative, hands-on comprehensive nursing curriculum that employs interprofessional efforts effectively supports learner outcomes and optimizes patient care.