The Effect of Clinical Nursing Practice Guidelines for Prevention of Aspiration in Stroke Patients with Dysphagia at Somdech Phra Pinklao Hospital
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Abstract
This one-group pretest-posttest quasi-experimental study aimed to: (1) compare the mean swallowing ability scores of stroke patients with dysphagia before and after the implementation of a clinical nursing practice guideline for aspiration prevention; and (2) compare the mean aspiration scores of stroke patients with dysphagia before and after the implementation of the same guideline. The sample consisted of 30 stroke patients with dysphagia who received treatment at Somdech Phra Pinklao Hospital. Participants were purposively selected based on inclusion criteria. The research instruments included: (1) a clinical nursing practice guideline for aspiration prevention in stroke patients with dysphagia; (2) a personal and health information questionnaire, which demonstrated good item-objective congruence (IOC) indices of 0.82 and 1.00, respectively; (3) the Gugging Swallowing Screen, which demonstrated good interrater reliability (k = 0.835); and (4) an aspiration assessment form. The content validity index (CVI) for these instruments was 0.80, and the Cronbach’s alpha coefficient was 0.94. Data were analyzed using descriptive statistics and the paired t-test. The results of the study revealed that the mean swallowing ability score of the participants after implementing the clinical nursing practice guideline was significantly higher than before (t = -6.28, p < .001). Additionally, the aspiration score of the participants after implementing the clinical nursing practice guideline was significantly lower than before (t = 5.93, p < .001). The findings of this study indicate that the clinical nursing practice guideline improves swallowing ability and reduces the risk of aspiration in stroke patients with dysphagia. Therefore, it should be implemented as a standard nursing practice to prevent aspiration in this population.
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