Article

This study assessed the positive and negative predictive values and the
sensitivity and specificity of a nursing dysphagia screening tool and the
National Institutes of Health Stroke Scale (NIHSS) for the identification of
dysphagia for veterans hospitalized with ischemic stroke.A secondary objective of
this study was to evaluate the speech-language pathology consult rate before and
after the nursing admission dysphagia screening tool. This retrospective cohort
study evaluated veterans admitted to one Department of Veterans Affairs medical
center with ischemic stroke during the 6 months both before and after the
implementation of a nursing dysphagia screening tool, which was part of the
admission nursing template. Stroke severity was measured with the use of the
retrospective NIHSS. Dysphagia diagnosis was based on speech-language pathology
evaluations.Dysphagia was present in 38 of 101 patients (38%) with ischemic
stroke. The nursing dysphagia screening tool had a positive predictive value of
50% and a negative predictive value of 68%, with a sensitivity of 29% and
specificity of 84%. The use of the NIHSS to identify dysphagia risk had a
positive predictive value of 60% and a negative predictive value of 84%.The NIHSS
had better test characteristics in predicting dysphagia than the nursing
dysphagia screening tool. Future research should evaluate the use of the NIHSS as
a screening tool for dysphagia.

Langue : ANGLAIS