Authors (including presenting author) :
Wong TS(1), HO PC(1), Kong CM(1), Duong KH(1), Yeung YC(1), Li WT(1), Yeung SM(1), Mok YNM(1)
Affiliation :
(1)Department of Medicine, Pamela Youde Nethersole Eastern Hospital
Introduction :
Post-Stroke Orophargneal Dysphagia (PSOD) is common for its high mortality and morbidity due to aspiration pneumonia and dehydration. Thickening agent is used to increase fluid viscosity reducing risk of fluid penetration to the airway as to maintain swallowing safety. However, lack of standardized FTEP in stroke units, many PSOD patients, caregivers and healthcare providers do not understand thoroughly the need of using thickened fluid resulting in a poor compliance. Besides, the correct application of thickener was found inconsistent. We recognised the importance and implemented FTEP to caregivers and healthcare providers in stroke units.
Objectives :
To enhance fluid swallowing safety on PSOD patients
Methodology :
This FTEP included individual education arranged for recruited PSOD caregivers and 4 identical talks for healthcare providers in stroke units of Pamela Youde Nethersole Eastern Hospital and Tung Wah Eastern Hospital from December 2018 to February 2019. Both groups received knowledge of PSOD, hand-on training on using thickener, video demonstration on correct feeding technique and chocking monitoring. Leaflet was provided to caregivers after individual talk. A designed knowledge test was implemented immediate and 1-week after education to evaluate the efficacy of the TFEP. Satisfaction questionnaire was given to review the feedback.
Result & Outcome :
Within 3 months, FTEP recruited total of 37 healthcare providers and 30 caregivers of PSOD patients who required thickened fluid. Comparing average pre-test and immediate post-test knowledge score of caregivers and healthcare providers were 5.8/12 to 9.78/12 (68.6% improvement) and 7.92/12 to 11.16/12 (40.9% improvement) respectively. Particularly in caregivers, passing rate increased from 13% (4 out of 30) to 100%. Comparing average 1-week and immediate after test score for caregivers and healthcare providers decreased from 9.78/12 to 7.85/12 (16% decrease) and 11.41/12 to 10.21/12 in healthcare providers (10% decrease) respectively. Furthermore, 96% caregivers remained good compliance using thickener for thin fluids after 1-week training. All participants expressed 100% satisfaction to FTEP. In conclusion, both groups got significant improvement in the knowledge and compliance of using thickener after attended FTEP. FTED is worth as routine training for all PSOD patients’ caregivers and healthcare providers in stroke units. Regular periodic assessment should be performed to maintain sustainability of compliance.
