The purpose of this study was to identify the current frequency, number and types of educational pedagogies, and best practice strategies used to teach dysphagia and swallow screening in California’s pre-licensure nursing programs.
Nurses are authorized to provide services that support the safety and protection of their patients. Central to the nursing role is a responsibility for patient safety in the administration of oral medications, fluids, and nutritional intake. Therefore, nurses are the key to early identification of patients who are at risk for aspiration.
Although nurses are increasingly expected to perform swallow screenings for patients and to request referrals for specialized dysphagia assessment and care, the literature reveals a significant gap in nursing curriculum related to dysphagia education. The purpose of this study was to identify the current frequency, educational pedagogies, and best practice strategies used to teach dysphagia and swallow screening in California’s pre-licensure nursing programs.
Results:
A total of 59 nursing program respondents representing ADN, BSN and ELM programs completed the survey for an overall response rate of 43%. In terms of the use of nurse swallow screening in the curriculum, 14 respondents (24%) stated that the content is not included in the curriculum. Thirty respondents (50%) used a reading assignment, 32 respondents (54%) offered didactic lecture, (31%) swallow screen skills lab demonstration with a return demonstration, and (10%) used simulation with standardized patient. Fifty-two respondents (89%) either agreed or strongly agreed that it was important to include swallow screenings in the curriculum.
Additionally, in response to the question: “Are nursing students in your program expected to perform swallow screenings while in the clinical setting?” Fifty respondents (85%) indicated that this was not an expectations of students. However, all students were expected to administer medications, fluids, and food to patients with oral intake orders when in the clinical setting.
Nursing curriculum should be revised to include content regarding swallowing disorders along with swallow screening tools which can be taught using didactic, lab training and/or other active learning pedagogies. This recommended revision to the curriculum will help future nurses identify those patients who are at risk for aspiration, reduce or prevent the incidents of non-ventilator associated pneumonias, and decrease pneumonia-related healthcare cost and death.