Effect of Early Dysphagia screening, Feeding Strategies and Oral Care on Occurrence of Stroke Associated Pneumonia among Critically Ill Patients with Acute Stroke

Background: Stroke-Associated Pneumonia (SAP) is a serious complication of post stroke dysphagia.It is one of the most common post-stroke infections, affecting approximately 37.3% of stroke patients and is associated with an increased risk of hospital mortality, prolonged ICU stay.Objective: To determine the effect of early dysphagia screening, feeding strategies and oral care on occurrence of stroke associated pneumonia among critically ill patients with acute stroke.Settings: The study was carried out at the general ICUs at two different hospitals namely: The general ICU "I","II" at Damanhur Medical National Institute, The general ICU and stroke ICU at kafr El-dawar Hospital.Subjects: A convenience sample of 60 adults newly admitted critically ill patients with a diagnosis of acute stroke were included in the study.Tools: Four tools were used for data collection.Tool(I) was "Early dysphagia screening tool" Gugging Swallowing Screen (GUSS) in addition to patient's sociodemographic and clinical data.Tool (II) was feeding strategies intervention tool.Tool (III) was oral care checklist.Tool (IV) was" assessment of Stroke Associated Pneumonia" tool.Results: Findings of the present study revealed that 13.3% of the study group developed SAP compared to 40% of the control group with a statistically significant difference between the two groups (p=0.02).Conclusion: Combination of early dysphagia screening, feeding strategies and oral care practices significantly decrease SAP occurrence among patients in the study group compared to those patients in the control group with routine hospital care.Recommendations: Combination of early dysphagia screening, feeding strategies and oral care practices should be applied to critically ill patients with post stroke dysphagia.