Nurse-Performed Bedside Dysphagia Screening for Post-Extubated Patients in ICUs
Care Process & Redesign
Workforce Transformation
National Healthcare Innovation and Productivity Medals
National University Health System
31 December 2020
To achieve 80% nurse competency in dysphagia screening, improve oral intake resumption within 48 hours, and reduce. Nurse-led dysphagia screening improved patient safety, reduced complications, and enhanced care efficiency in ICUs.
Year Submitted: 2020
Published Date: 31 December 2020
Tags: Care Process ＆ Redesign, Workforce Transformation, Quality Improvement, Clinical Practice Improvement, Workflow Redesign, Value Based Care, Safe Care, Job Redesign, Upskilling
About this Content
Aims
To achieve 80% nurse competency in dysphagia screening, improve oral intake resumption within 48 hours, and reduce reintubation, pneumonia, and hospitalization.
Background
Post-extubation dysphagia (PED) occurs in 62% of ICU patients after prolonged intubation, increasing risks of pneumonia, reintubation, and longer hospital stays. The absence of standardized nurse-led dysphagia screening delayed oral resumption.
Methods
Implemented a standardized Nurse-Performed Screening (NPS) protocol using the PDSA model. Provided structured training for ICU nurses, competency assessments, and compliance audits.
Results
Achieved 100% nurse competency in dysphagia screening. Oral intake resumption within 48 hours improved from 32% to 76%. Reintubation rates reduced from 71% to 12%, and post-extubation pneumonia rates decreased by 7%.
Conclusion
Nurse-led dysphagia screening improved patient safety, reduced complications, and enhanced care efficiency in ICUs. Sustained through annual audits and refresher training.
Lessons Learnt
Multidisciplinary teamwork, leadership alignment, and structured training were critical to success. Regular audits and booster sessions sustained competency and compliance.
Additional Information
Screening protocol scaled for ICU departments hospital-wide, with potential adaptation for other high-risk populations.
Keywords
Clinical Improvement, Dysphagia Screening, Post-Extubation Care, Nurse-Led Protocols, ICU, Quality Improvement, Patient Safety, NUH
Innovators' Details
Innovators' Details
Healthcare Cluster(s) | National University Health System |
Organization(s) Involved | National University Hospital |
Platform(s) | National Healthcare Innovation and Productivity Medals |
Healthcare Professional Group(s) | Allied Health, Nursing |
Applicable Specialty or Discipline | Pulmonology, Respiratory Therapy, Intensive Care Medicine |
Project Lead(s) | Yong Ying Bing |
Project Member(s) | Chua Hsu Fung Cindy |
Connect with this contributor!
Yong Ying Bing - ying_bing_yong@nuhs.edu.sg
Project Attachment
37_NUH_NHIP_2020_CR_Winner_1_Nurse_Performed_Bedside_Dysphagia_Screening_combine.pdf