Walking a new path: changing the post-operative pathway to optimise dysphagia management in hip fracture
Stephanie Greer1 1The Prince Charles Hospital
Abstract
Background
Population ageing is a major challenge health care systems world-wide are currently facing (WH0, 2022). Subsequently, innovative Speech Pathology (SP) service development in the geriatric acute hospital setting is required to deal with increasing demand.
Aim
This project explored a nursing staff (NS) led screening protocol, to facilitate the early identification and management of acute oropharyngeal dysphagia, on The Prince Charles Hsopital (TPCH) fractured neck of femur (#NOF) ward.
Methods of implementation
A pragmatic two-phase approach was employed. In the first phase, The Royal Brisbane Women’s Hospital Dysphagia Screening Tool (RBWH DST) was used by an SP to screen thirty consecutive post-operative #NOF patients, in a two-month period. The first phase was completed to ensure the screening tool was sensitive to this cohort prior to transitioning to NS led implementation. In the second phase, the RBWH DST was implemented by the NS to screen thirty-six consecutive post-operative #NOF patients, in a two-month period.
Results
The NS led screening protocol reduced SP hours dedicated to assessing the #NOF post-operative patients from thirty-six hours to sixteen hours during the implementation period. Additionally, the NS accurately screened patients ‘at risk’ for oropharyngeal dysphagia post-operatively in the #NOF population with nil patients that passed the RBWH DST being referred for SP assessment during their admission.
Conclusion
The reduction in hours facilitates continued disinvestment in potentially lower value care and facilitates reinvestment of resources to areas of higher need. The future recommendation would be for the NS to continue screening the #NOF post-operative patients using the RBWH DST.
Biography
Biographies to come.