The swallowing dysfunction constitutes a problem of high morbidity, mortality and costs, often associated with serious consequences for the health of those affected, however it has not deserved a particular attention, both by risk management and quality of care programs. Nurses are the health professionals that due to their technical profile and patients’ proximity who can further and effectively interfere in order to reduce the risk of complications and, thus, increasing the patient safety to feeding. Our health intervention was developed with a home team of long term health care (ECCI) of the Community Care Unit (CCU) Gentes de Loulé, Portugal. With the implementation of this project the goal was to develop the nursing team skills regarding its intervention in swallowing capacity, and increasing up to 20% the registration frequency of intervention, until January 2013. The objectives were defined as follows: 1. To implement a training program on swallowing capacity in order to develop theoretical and practical nursing skills intervention in the area, achieving a rate of correct answers of 60% through a theoretical evaluation questionnaire and 60% of agreement in the practical assessment; 2. To create a tool to support nursing intervention and registration related to swallowing capacity and to test it; 3. To improve recording frequency of nursing interventions related to swallowing capacity, going from 6,3% to 20%. It was followed the health planning methodology. It was carried out a systematic review of the literature on clinical evaluation methodology concerning swallowing capacity. They were held two epidemiological studies, one diagnostic and other for evaluation. It was created a tool to support nursing intervention that has been tested regarding its attributes of content validity and interrater reliability. It was implemented a program of theoretical and practical training that has been evaluated. They were held formal and informal meetings with the ECCI. As results, in the evaluation of the training program, it was achieved 37% of theoretical knowledge improvement rate and an agreement proportion of 93.4% in the evaluation of the procedures. Testing the tool, the following overall results were obtained: Po = 93.4%, excellent; ICC = 0.927, excellent; Kendall`! - b = 0.875, excellent; Kappa (p) = 1.000, excellent. The literature review concluded that there is no consensus regarding the most appropriate methodology and about the items to be included to evaluate the swallowing capacity. The epidemiological studies have shown, among other data, that 86% of the ECCI population presents antecedents considered of risk concerning swallowing dysfunction. The prevalence of this dysfunction was, in the first study, of 6.8% and 18.3% in 2nd study. The frequency of registration of nursing interventions related to swallowing disorders increased to 37%. As conclusions, the objectives and the goal were achieved. We believe that the value of nursing intervention in feeding may be converted into gains in safety, thus in care quality, and therefore, gains in peoples health, which, in turn, may represent significant economic gains for the NHS.
Date of Award | 2014 |
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Original language | Portuguese |
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Awarding Institution | - Universidade Católica Portuguesa
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Supervisor | Teresa Rasquilho Vidal (Supervisor) |
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Segurança do doente à alimentação: intervenção de enfermagem na capacidade de deglutição
Carvalhal, A. L. R. D. C. (Student). 2014
Student thesis: Master's Thesis