Stroke and ischaemic attack: 4-hour swallowing assessment

Indicator type

Network / system level indicator.

The indicator would be appropriate to understand and report on the performance of networks or systems of providers.

Rationale

Swallowing difficulties can result in aspiration and reduced oral intake for people with stroke. These in turn can lead to the potentially serious complications of pneumonia, undernutrition and dehydration. This indicator aims to identify those individuals at risk as soon as possible, as these complications may be avoidable or reversible.

Source guidance

Stroke and ischaemic attack in over 16s: diagnosis and initial management. NICE guideline NG128 (2019), recommendation 1.6.1

National clinical guideline for stroke. Royal College of Physicians clinical guideline (2016), recommendation 4.16.1.A (NICE-accredited guideline)

Specification

Numerator: The number of patients in the denominator in whom swallowing is screened within 4 hours of admission (or within 4 hours of onset of stroke for those patients who are already in hospital at the time of the stroke) by a healthcare professional trained in dysphagia screening, before being given any food, fluid or medication orally.

Denominator: The number of stroke patients admitted to hospital.

Calculation: Numerator divided by the denominator, multiplied by 100.

Exclusions:

Data source: Sentinel Stroke National Audit Programme (SSNAP).

Minimum population: The indicator would be appropriate to assess the performance of networks or systems of providers.

ISBN: 978-1-4731-5573-2