Dysphagia screening tools for acute stroke patients available for nurses: A systematic review

Background Aim: There is a high incidence of dysphagia after stroke that, depending on the assessment, methodology and time elapsed, can range from 8.1% to 80%. Early and systemic dysphagia screening is associated with a decreased risk of aspiration pneumonia and prevents inadequate hydration/nutrition. The purpose of this systematic review was to identify dysphagia screening tools for acute stroke patients available for nurses validated against reference test. The research question was: which dysphagia screening tools for acute stroke patients available for nurses? #xD; Methods Materials: Three electronic databases were searched from January 2007 to November 2017: on PubMed, Scielo and CINAHL Plus. Two independent reviewers screened all titles and abstracts, assessed methodological quality and extracted data. The methodological quality analysis and evaluation was guided according to four domains: patient selection, index test, reference standard and flow and timing. Divergences between reviewers in data extraction were consensualized through discussion. #xD; Results: From the 377 articles retrieved, only three articles met criteria for review: BarnesJewish HospitalStroke Dysphagia Screen; the Gugging Swallowing Screen and, The Toronto Bedside Swallowing Screening Test. None of the screening tools complies with all psychometric properties, which means that a still significant proportion of patients will be kept nil by mouth without being necessary or that some patients will #x201C;fall through the cracks #x201D; interrupting the diagnostic process. The tools identified are different from each other, making their comparison impracticable. #xD; Conclusion: Due to psychometric proprieties and dietary recommendations adjusted to dysphagia severity, of all available tools, GUSS is a suitable screening tool for nurses in clinical practice.