EBP Compendium: Summary of Clinical Practice Guideline

Ontario Guidelines Advisory Committee
Best Practice Guidelines for Stroke Care
Ontario Stroke System (2003).
Ontario (Canada): Heart & Stroke Foundation

AGREE Rating: Recommended with Provisos

Description:

This guideline provides recommendations pertaining to stroke prevention, identification, assessment, and management. These guidelines are intended for a wide audience.  

Recommendations:

• Assessment/Diagnosis
  • Assessment Areas
    • Swallowing and Language
      • The care guides (pp. 71-107) include best practice recommendations for various stages of stroke care and rehabilitation. The recommended time frame for SLP screening, assessment, and management of dysphagia, aphasia, and other cognitive-communicative impairments is discussed in detail for each stage.
  • Assessment Instruments
    • Swallowing
      • Bedside Swallow Examination and Videofluoroscopy 
        • “Routine bedside screening is useful to detect stroke survivors who aspirate. However, because 1/3 - 1/2 of individuals who aspirate do so silently, without coughing, clinical assessment may not detect aspiration in these cases.
        • Videofluoroscopic modified barium swallow may be required in selected cases” (p. 48).
• Treatment
• Language
• “The family and caregivers should be involved in the treatment plans for aphasia to help re-establish functional communication” (p. 50).

Keywords: Stroke

Access the Guideline

Added to Compendium: October 2011