Sensitivity and Specificity of a Nurse Dysphagia Screen in Stroke Patients

Abstract

Purpose: To determine how well an institutionally developed nurse dysphagia screening tool correctly identified the presence (sensitivity) or absence (specificity) of dysphagia in patients following acute stroke.

Methods: A method-comparison design was used to compare results of the Nurse Dysphagia Screen to the dysphagia evaluation by a speech and language pathologist (SLP). Each newly diagnosed participant served as his or her control, with both dysphagia evaluations (nurse, SLP) occurring within 2 hours of each other. Sensitivity and specificity of the Nurse Dysphagia Screen was calculated using standard formulas.

Results: For 49 patients evaluated following stroke, average age was 71.7 (SD +/- 13.5). Twenty-five subjects were female and 24 were male. The majority of the participants had strokes identified as ischemic in origin (n=35). The SLP found 18 (37%) participants had a positive dysphagia assessment. The Nurse Dysphagia Screen was positive in 16 of 18 participants screened positive by SLP, resulting in some type of dietary restriction. The Nurse Dysphagia Screen was negative in 28 of the 31 patients screened as negative by SLP. Sensitivity and specificity of the Nurse Dysphagia Screen were 89% and 90%, respectively.

Conclusions: An easy-to-use, institutionally developed nurse dysphagia screening tool successfully identified patients with swallowing difficulties after stroke later diagnosed by SLP.