American Speech-Language-Hearing Association

EBP Compendium: Summary of Clinical Practice Guideline

American Association of Neuroscience Nurses; Genentech
Guide to the Care of the Hospitalized Patient with Ischemic Stroke

American Association of Neuroscience Nurses. (2008).
Glenview (IL): American Association of Neuroscience Nurses, 38 pages.

AGREE Rating: Recommended with Provisos

Description:

This guideline provides recommendation for the assessment and management of individuals with acute stroke. The target audience of this guideline is primarily physicians and nurses involved in the acute management of stroke care.

Recommendations:

  • Assessment/Diagnosis
    • Assessment Instruments
      • Swallowing
        • Bedside Swallow Assessment
          • "Swallow assessment should be performed as soon as possible after admission to the hospital,no later than 48 hours after admission" (p. 22).
          • Individuals with suspected aspiration should receive a bedside swallow assessment prior to initiating oral intake.
          • "Clinical interventions after the initial nursing swallow screen include consulting the speech and language pathologist (SLP) for formal evaluation and further recommendations on diet or techniques for decreasing the risk of aspiration" (p. 22).
        • FEES/Videofluoroscopy - Bedside videoflouroscopic or endoscopic assessment can be used to evaluate for dysphagia.
  • Treatment
    • Swallowing
      • General Findings - SLPs will develop treatment plan to reduce risk of aspiration including the training and use of positioning techniques, diet modification, oral care and monitoring of pulmonary status.  

Keywords: Stroke; Clinical Bedside Assessment

Access the Guideline

Added to Compendium: November 2011

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