Assessing adherence to the evidence base in the management of poststroke dysphagia

Burton, C.R.; Pennington, Lindsay; Roddam, Hazel; Russell, Ian; Russell, Daphne; Krawczyk, Karen; Smith, Hilary A.

doi:10.1191/0269215506cr903oa

Cited by 9 publications

(4 citation statements)

References 6 publications

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“…Six studies focused on a single intervention strategy10 30 35 37 39 42 and seven on a multi-faceted strategy 20 22 24 25 29 34 36 43. One study compared both single and multi-faceted implementation strategies 32.…”

Section: Resultsmentioning

confidence: 99%

Guideline implementation in allied health professions: a systematic review of the literature

Hakkennes

Dodd

2008

Quality and Safety in Health Care

173

159

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There is no evidence to support a set guideline implementation strategy for allied health professionals. When implementing clinical guidelines it is important to first identify specific barriers to change using theoretical frameworks of behaviour change and then develop strategies that deal with these barriers. When measuring the effectiveness of these strategies, professionals should consider the use of both patient and process outcomes and choose outcomes that reflect their aims.

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Section: Resultsmentioning

confidence: 99%

Guideline implementation in allied health professions: a systematic review of the literature

Hakkennes

Dodd

2008

Quality and Safety in Health Care

173

159

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“…Two also reported that they had other clinical governance training priorities at the time of recruitment and were unable to take on extra commitments. Of the 18 departments agreeing to join the study four in the northern part of the region took part in the pilot phase. The remaining departments joined the main phase of the trial.…”

Section: Recruitmentmentioning

confidence: 99%

Promoting research use in speech and language therapy: a cluster randomized controlled trial to compare the clinical effectiveness and costs of two training strategies

et al. 2005

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Training in research implementation in addition to critical appraisal and guideline introduction is associated with increased dissemination activities and awareness of research information, but not with changes in clinical practice within six months of training. The department in which SLTs work influences their use of research. The process of poststroke dysphagia management can be measured using a tool developed from practice guidelines.

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“…Despite the emphasis placed on assessing for dysphagia, the management of the consequences of dysphagia was only considered by three documents reviewed. No consistency in management processes was found with one paper considering the vague process that alternative means of hydration and nutrition need to be considered as soon as possible (23) and another considering modified diet only (29). A third paper considered the optimal method of enteric nutritional delivery, advocating the use of percutaneous endoscopic gastrostomy (PEG) feeding if artificial support was needed past 2-weeks; however, this process does not correlate with recommendations in the current stroke guidelines (12, 13, 22).…”

Section: Discussionmentioning

confidence: 99%

Measuring the Quality of Dysphagia Management Practices following Stroke: A Systematic Review

Wall

Bernhardt

Edwards

et al. 2010

International Journal of Stroke

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Title and abstract review found 150 potential studies. Full-text review resulted in 25 publications that met the study's inclusion criteria. Thirteen process indicators were identified in the literature that related to the initial assessment, clinical management, rehabilitation and discharge planning for patients with acute stroke-related dysphagia. These processes were supported by levels of evidence ranging from high 'level 1' (8%) down to 'expert opinion' evidence (46%). Two process indicators did not align to recommendations in the clinical guidelines. This systematic review underpins informed selection of process indicators for evaluating the quality of dysphagia management following stroke. The selection of quality indicators is complicated by equivocal supporting evidence; however, indicators should reflect expected local practices, align with national stroke guidelines and be feasible for clinical auditing.

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Assessing adherence to the evidence base in the management of poststroke dysphagia

Abstract: The audit tool has high face validity and measurement reliability. The use of a composite adherence score should, however, proceed with caution as internal consistency is low.

Cited by 9 publications

References 6 publications

Guideline implementation in allied health professions: a systematic review of the literature

Guideline implementation in allied health professions: a systematic review of the literature

Promoting research use in speech and language therapy: a cluster randomized controlled trial to compare the clinical effectiveness and costs of two training strategies

Measuring the Quality of Dysphagia Management Practices following Stroke: A Systematic Review

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