TY - JOUR

T1 - Intensive care professionals’ perspectives on dysphagia management

T2 - A focus group study

AU - Nielsen, Anne Højager

AU - Kaldan, Gudrun

AU - Nielsen, Birthe Husted

AU - Kristensen, Gitte Juhl

AU - Shiv, Louise

AU - Egerod, Ingrid

N1 - Funding Information: Anne Højager Nielsen was funded by the Novo Nordisk Foundation , grant number 0058227 . The funder did not influence the design of the study, the acquisition of data, analysis, conclusion, or decision to publish.

PY - 2023

Y1 - 2023

N2 - BackgroundIntensive care unit (ICU)–acquired dysphagia has severe consequences for patients including increased morbidity and mortality. Standard operating procedures, however, including systematic evaluation of swallowing function and access to specialised assessment and training may be limited. Dysphagia management relies on multiprofessional collaboration, but practice is variable and nonstandardised.ObjectiveThe objective of this study was to explore and compare nurses', physicians’, and occupational therapists' perceptions of dysphagia management in the ICU.Materials and methodsSix focus group interviews with 33 participants (23 nurses, four physicians, and six occupational therapists) were conducted and analysed using the framework method with a matrix developed from the first interview. Content from the interviews was plotted into the matrix, condensed, and refined.FindingsClinical dysphagia management depended on recognising signs of dysphagia in patients at risk. Assessment, therapeutic methods, and care differed among professional groups according to knowledge and roles. Interprofessional collaboration and responsibility for dysphagia management across the care continuum was determined by availability of resources, practical skills, knowledge, and formal decision-making competence and judged effective when based on mutual respect and recognition of healthcare professionals' different perspectives.ConclusionSystematic interprofessional collaboration in ICU dysphagia management requires working towards a common goal of preventing aspiration and rehabilitating the patients' ability to swallow safely. This is based on dysphagia assessment, using appropriate therapeutic interventions, sharing knowledge, and improving skills among professional groups.

AB - BackgroundIntensive care unit (ICU)–acquired dysphagia has severe consequences for patients including increased morbidity and mortality. Standard operating procedures, however, including systematic evaluation of swallowing function and access to specialised assessment and training may be limited. Dysphagia management relies on multiprofessional collaboration, but practice is variable and nonstandardised.ObjectiveThe objective of this study was to explore and compare nurses', physicians’, and occupational therapists' perceptions of dysphagia management in the ICU.Materials and methodsSix focus group interviews with 33 participants (23 nurses, four physicians, and six occupational therapists) were conducted and analysed using the framework method with a matrix developed from the first interview. Content from the interviews was plotted into the matrix, condensed, and refined.FindingsClinical dysphagia management depended on recognising signs of dysphagia in patients at risk. Assessment, therapeutic methods, and care differed among professional groups according to knowledge and roles. Interprofessional collaboration and responsibility for dysphagia management across the care continuum was determined by availability of resources, practical skills, knowledge, and formal decision-making competence and judged effective when based on mutual respect and recognition of healthcare professionals' different perspectives.ConclusionSystematic interprofessional collaboration in ICU dysphagia management requires working towards a common goal of preventing aspiration and rehabilitating the patients' ability to swallow safely. This is based on dysphagia assessment, using appropriate therapeutic interventions, sharing knowledge, and improving skills among professional groups.

KW - Deglutition

KW - Deglutition disorders

KW - Dysphagia

KW - Intensive care

KW - Interprofessional care

U2 - 10.1016/j.aucc.2022.04.004

DO - 10.1016/j.aucc.2022.04.004

M3 - Journal article

C2 - 35610091

AN - SCOPUS:85130553212

VL - 36

SP - 528

EP - 535

JO - Australian Critical Care

JF - Australian Critical Care

SN - 1036-7314

IS - 4

ER -