LAUSR

Background: The national stroke guidelines recommend that swallow screening in stroke patients should occur at between 3 and 24 hours after presentation, and prior to commencing any oral intake, standards which were used in the National Stroke Audit 2015 [1]. The aim of this audit was to assess the timing of swallow screening in our hospital and factors affecting this. Method: The charts of 20 acute stroke patients over a 2 month period were reviewed. Demographic details, time of presentation and timing of swallow screening were extracted. Results: The patients included had an average age of 76.5 years (range 64–88). 2 patients (10%) had a swallow screen within 4 hours of presentation and 11 (55%) within 24 hours. 11 patients (55%) presented outside of normal working hours. The average time to screening was 26 hours, 19.6 hours for those presenting in normal working hours and 32.4 hours for those presenting out of hours. 5 (29%) were screened by a nurse, 12 (71%) by a Speech and Language Therapist. 3 patients (15%) had no swallow screen documented. 6 (30%) were not kept NPO until screened. Conclusions: The data for our hospital, while in line with the National Stroke Audit figures1, leaves significant room for improvement in rates and timing of swallow screening. Junior doctors require education on the necessity of swallow screening prior to oral intake as part of initial stroke management, to minimise the risk of aspiration pneumonia. The majority of stroke presentations were out of hours, resulting in delays to swallow screening. This highlights the need for availability of trained nursing staff as part of the development of co-ordinated stroke care in our hospital. Reference 1. McElwaine P, McCormack J, Harbison J. on behalf of the National Stroke Programme Audit Steering Group Irish Heart Foundation/HSE National Stroke Audit 2015