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Lack of nurses trained in a vital technique for stroke care

Royal College of Physicians audit recommends training in swallow screening 

All nurses working in post-acute stroke services should be trained in swallow screening before treating patients, a national study has found.

The Sentinel Stroke National Audit Programme (SSNAP), run by the Royal College of Physicians, made the recommendation in an audit report published today.

The report looks at the organisation of care for stroke patients once they left an acute hospital and were treated in 604 post-acute stroke services in England, Wales and Northern Ireland, including community hospitals, outpatient clinics and patients' homes.

Swallow screening is designed to ensure patients are well enough to take food, water and medicine. The technique can detect difficulty with swallowing – known as dysphagia – and can also reduce the risk of pneumonia.

Yet the study results, which reflect the state of services as of April 1 this year, found that a median of zero nurses on duty per 10 stroke beds in post-acute services at 10am were trained in the technique.

The report recommends that all nurses based in post-acute inpatient services who treat stroke patients should be trained in swallow screening. 

Additionally the report advises a waiting time of no more than 24 hours for early supported discharge teams to see patients after discharge from an acute hospital – something that 40% of the post-acute stroke services failed to ensure.

Patient reviews should also happen within 14 days, the report states, and where additional rehabilitation is needed following discharge, this should take no longer than 90 days to begin following referral.

Read the full report here