Nutritional risk management for stroke survivors with dysphagia in a rehabilitation department: a best practice implementation project.

INTRODUCTION

Stroke survivors with dysphagia face a greater risk of malnutrition and life-threatening complications, yet evidence-based nutritional management in this population remains underutilized in clinical practice.

OBJECTIVE

This project aimed to implement and evaluate an evidence-based standardized nutritional risk management program for stroke survivors with dysphagia in a rehabilitation department in a hospital in China.

METHODS

This evidence implementation project was conducted using the JBI Evidence Implementation Framework, which is grounded in an audit and feedback process, along with a structured approach to identifying barriers to best practice recommendations. The audits included 28 health care professionals. Patient participation was 41 at baseline, 45 at first follow-up, and 46 at second follow-up. Compliance with 27 evidence-based audit criteria was evaluated, and four key barriers were identified, with corresponding change strategies implemented to address them. Data were analyzed using descriptive statistics, ANOVA, and χ2 tests.

RESULTS

The majority of audit criteria showed significant improvement in compliance: 13 reached 100%, while the remaining 14 achieved a compliance rate exceeding 84%. Health care professionals' knowledge scores of nutritional management demonstrated a significant increase across the three audit cycles, rising from 12.21 ± 3.201 at baseline to 19.18 ± 2.611 in the second follow-up audit ( F  = 48.102, p  < 0.001). Similarly, patients'/caregivers' knowledge scores increased significantly from 9.00 ± 2.674 to 16.48 ± 2.987 ( F  = 78.835, p  < 0.001). Analysis across all audits revealed a significant reduction in both the incidence of hypoalbuminemia (from 17.1% to 2.2%; p  = 0.048, Fisher's exact test) and complication rates (from 48.8% to 10.9%; χ2  = 17.476, p  < 0.001).

CONCLUSIONS

The project successfully integrated evidence-based nutritional risk management into clinical practice, demonstrating that multidisciplinary team collaboration, systematic training, and protocol standardization can significantly enhance evidence-based practice and may improve patient outcomes. To ensure sustainability, ongoing education, regular audits, and expansion to other clinical units are recommended.

SPANISH ABSTRACT: https://links.lww.com/IJEBH/A676.