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Development of Nursing Practice Guidelines for Managing Dysphagia in Stroke
Patients to Prevent Aspiration Pneumonia in the Stroke Unit at Uttaradit Hospital

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P. Jandahan and S. Khunkaew 1

Faculty of Nursing, Praboromarajchanok Institute, Thailand
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Background: Dysphagia is a prevalent issue among stroke patients, often resulting in aspiration,
which is the second leading cause of mortality in this population. Therefore, implementing effective
swallowing training protocols is essential for preventing aspiration pneumonia, both during
hospitalization and post-discharge. However, there are limited nursing practice guidelines for
managing dysphagia in stroke patients to prevent aspiration pneumonia in specific contexts.

Objective: The purpose of this study was to develop nursing practice guidelines for managing
dysphagia in stroke patients to prevent aspiration pneumonia in the stroke unit at Uttaradit Hospital.

Methods: This Clinical Nursing Practice Guideline (CNPG) was established using the evidence-based
practice (EBP) model of Soukup (2000) as a conceptual framework. The evidence-based practice model
comprised four phases: 1) Evidence Triggered Phase, 2) Evidence Supported Phase, 3) Evidence Observed
Phase, and 4) Evidence Based Phase. Studies were evaluated based on credibility and feasibility of
implementation. A total of seven evidence-based practice studies were included, consisting of six level
2c and one level 2d. The sample comprised ten stroke patients. The research tools included the National
Institutes of Health Stroke Scale (NIHSS), Glasgow Coma Scale, Dysphagia Screening Tool, and a Satisfaction
Questionnaire. Data were analyzed using descriptive statistics.

Results: The mean age of participants was 72.75 years, with a range of 61-84 years. NIHSS scores
ranged between 1-4 (mild) (40%) and 5-16 (moderate) (60%). The Glasgow Coma Scale scores
ranged from 12-15. After the intervention, 70% of the sample were able to consume food without
aspiration. Additionally, the satisfaction score was high (X̄̄ = 4.57, SD = 0.55) regarding feasibility and
Poster Presentation Abstracts
practicality for clinical use.

Conclusion: These findings indicate that the CNPG is appropriate for preventing aspiration pneumonia
in the stroke unit at Uttaradit Hospital.

Keywords: dysphagia, stroke patients, aspiration pneumonia

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Correspondence: Saneh Khunkaew, Faculty of Nursing, Praboromarajchanok Institute, Thailand
E-mail: saneh@pi.ac.th

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