It’s a perfect score for QEII Hospital’s Emergency Department (ED), where the nursing team have achieved 100 per cent compliance in Dysphagia Screening Tool (DST) assessment completion for two consecutive months.
DST is a swallowing safety assessment tool that screens stroke patients for swallowing difficulty (Dysphagia) before proceeding oral intake of food, fluids, or medication.
Implemented as part of a hospital-wide quality improvement project, the DST compliance improvement initiative was led by Stroke CNC and champion of advancing stroke care, Jessica Wood.
From proactive consultation with the Stroke Foundation and Australian Stroke Clinical Registry, to interprofessional collaboration with ED, the nursing powerhouse worked closely to deliver the program across ED.
“In ED, we have a lot of things that we need to think about every day,” said ED CNC, Sara Hatten-Masterson.
“We’re really grateful that Jessica was able to work with us and take on the bulk of that workload so we could focus on getting our ED team to understand the how and the why of this initiative, and to support each other to achieve that.”
Sara says the initiative is not a box-ticking exercise, but a learning journey for both staff and patients.
“Human nature is to use food and drink as comfort. Patients and their families will often ask when they can have something to eat or drink, and that’s why education is important at both sides. If we understand how and why we do the DST, and we can do it in a timely way, we can help our patients and their families understand it, too.”
Thanks to an ED-friendly training course combining an online module and a one-off practical training element supported by a senior nurse, staff across the busy ED have upskilled in record time.
“The online module provides a strong theory base, and the practical component allows staff to get hands-on and apply that theory on the floor with the support of a senior nurse. It’s a complementary training package and it’s efficient, so it works really well in the ED environment,” said Sara.
By April the team doubled the DST score across the unit, reaching 100 per cent compliance and achieving a 12-month goal in half the time.
“What’s great about this initiative is the black-and-white data that comes from it. 100 per cent is a testament to how hard everybody’s working, and people can see the difference it’s making,” said Clinical Facilitator Bethne Fonmoa.
While the numbers speak for themselves, Bethne says the positive impact of the initiative goes beyond statistics, telling a story of teamwork and an evolving culture throughout the department.
“Between the nurses, medical team and the Speech Therapists who come down to help, we’re all coming together and that has really boosted the culture of ED,” she said.
“As a multidisciplinary team, this has helped us work really well and closely together to get some really positive outcomes, which helps both patients and the staff on the floor.”
Congratulations to the whole team on this fantastic achievement.