A nurse-led dysphagia rehabilitation program in the acute stroke unit

Abstract

Background and Purpose: Dysphagia is one of the most important dysfunctions occurring among stroke patients. The purpose of this study was to clarify the effectiveness of a nurse-led dysphagia rehabilitation program in the acute stroke unit. Methods: We prospectively studied 96 consecutive stroke patients at the acute phase admitted to our stroke unit (mean age, 69.9 years). Nurses examined all the patients for dysphagia on admission. A structured swallowing training program was provided for those patients with dysphagia. Medical doctors and rehabilitation staff belonging to the stroke ward participated in the program interdisciplinarily. Progress in functional levels of oral intake, length of stay (LOS), NIHSS, and occurrence of pneumonia were the main outcome measures. Results: 34.3% (33/96) of the patients had dysphagia (the dysphagia group). The mean NIHSS score in the dysphagia group was higher than that in the normal group (8.3 versus 5.0; p<0.05). The mean LOS in the dysphagia group was 27.1 days as compared to 18.3 days in the normal group (p<0.01). The levels of oral intake improved in 81.8% (27/33) of the patients. Only one patient developed pneumonia during the hospital stay. Conclusions: The present study demonstrated that nurse-led dysphagia rehabilitation in the stroke unit can reduce the risk of aspiration pneumonia and promote the oral intake of patients with dysphagia. Nursing care is indispensable for stroke unit care against dysphagia.