Dysphagia refers to difficulty swallowing and can be potentially life-threatening due to malnutrition, dehydration, aspiration pneumonia, and other complications, including death (Cichero, Heaton, & Bassett, 2009; Johnson, Brody, Marcus, &Touger-Decker, 2015). Proper identification of dysphagia ensures the correct and safe provision of foods and medications. When dysphagia is not recognized, it can result in aspiration of oral contents, which occurs in 15-30% of hospital patients (Cichero et al., 2009). The majority of these patients are aged 65 years and older (Cichero et al., 2009). Persons at greater risk for dysphagia in the hospital setting include those with surgery to the head or neck, progressive neurological conditions, head injury, respiratory disorders, radiation or chemotherapy to the head and neck, autoimmune disorders, cardiac surgery, and psychiatric conditions. Also, those who have suffered a stroke are at high risk of dysphagia (Cichero et al., 2009; Heiss, Goldberg, Dzarnoski, 2010). The consequences of dysphagia can be exacerbated in patients diagnosed with stroke (Massey & Jedlicka, 2002). Stroke diagnosed with dysphagia are more likely to develop other medical conditions and complications, or even death (Wirth, Smoliner, Jager, Warnecke, Leischker, & Dziewas, 2013). An effective dysphagia screening process may aid in the detection of dysphagia in stroke patients in the hospital setting. The National Stroke Foundation in Australia mandated that all stroke patients be screened for dysphagia within 24 hours of the stroke and before given oral intake (Cichero et al., 2009). The American Heart Association and the American Stroke Association have also included screening for dysphagia for stroke patients before administering any food, liquid, or medication (Daniels, Anderson, & Peterson, 2013). When dysphagia is detected early in stroke patients, it increases the likelihood of preventing complications such as aspiration and malnutrition and initiates the treatment process (Massey & Jedlicka, 2002). Screening for dysphagia has primarily been the responsibility of speech-language pathologists; however, researchers have called for training programs that include other staff, such as nurses and dietitians, in the screening process (Cichero et al., 2009; Johnson et al., 2015). This effort has been deemed an interprofessional approach so as to expedite patient referrals to the speech-language pathologist. However, these other healthcare professionals are not necessarily trained to screen for dysphagia; therefore, a need has arisen to develop effective training programs and screening tools to facilitate dysphagia screening by these personnel. As part of a health care team, dietitians can participate in the process of screening stroke patients for dysphagia. In order to do this effectively, they must have an effective screening tool and be trained on how to use the tool. In the proposed investigation, a researcher-developed dysphagia screening tool training program will be evaluated for effectiveness with registered dietitians to screen stroke patients.
