The Rapid Aspiration Screening in Suspected Stroke Part 2: Initial and Sustained Nurse Accuracy and Reliability

Publication date: Available online 24 April 2016
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Jane A. Anderson, Shweta Pathak, John C. Rosenbek, Robert O. Morgan, Stephanie K. Daniels
ObjectivesThe aim of this study was to determine registered nurses' (RNs) ability to obtain and maintain accurate procedural skills and reliable interpretation of the Rapid Aspiration Screening for Suspected Stroke (RAS³).DesignProspective, observation studySettingA certified primary stroke center in a major metropolitan facilityParticipantsA total of 15 RNs were recruited and trained in the administration and interpretation of the screening items under study to develop the RAS³.InterventionsRNs completed a total of 239 screenings of patients admitted with suspected stroke over a 2 year period. RNs administered the swallowing screening items (SSI) and interpreted the patient's response for each item. Independent to the RN, a speech-language pathologist simultaneously interpreted the stroke participant's response to each SSI.Main Outcome MeasuresReliability of interpretation and accuracy of administering SSIsResultsAverage accuracy rate for administration of the RAS3 was 98.33% with the overall accuracy rate for each procedural task ranging from 95.42% to 100%. For the specific SSIs that formed the RAS³, dysarthria and a positive sign after water swallow, reliability was very high (k=0.817). Accuracy rate for administration and reliability in interpretation of the SSIs improved as the RNs gained experience, and both were maximized at 20 screening opportunities.ConclusionsRNs demonstrate both excellent accuracy in procedural administration and reliability in item interpretation of the RAS³. With feedback and repeated opportunities to practice, maintenance of skills is achievable.



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