Abstract TP225: Achievng 100% Swallow Screen Compliance

Background: Sutter Auburn Faith Hospital (SAFH) is a Primary and Rural Stroke Center that sees over 300 stroke patients a year.In 2024 SAFH saw a decrease in swallow screen compliance due to an increase of primary complaint presentation to the Emergency Department (ED) of confusion or dizziness who were later diagnosed with a stroke.This resulted in a decrease in our swallow screen compliance to 92.8%. Purpose: The purpose of this quality improvement project was to increase swallow screen compliance in stroke patients. Methods: SAFH completed a gap analysis of 2024 Q1-Q3 data, revealing that ED patients presenting with dizziness or increased confusion were most often missed for swallow screens.The gap analysis revealed that these patients received a head CT that did not result in an initial diagnosis of stroke but were admitted for other pathologies.The team identified the swallow screen as a nurse driven intervention that should be completed on all patients who are prescribed a head CT.In response the quality improvement project, “Swallow screen for head CT” was launched including RN Educationfor posterior stroke symptoms. The Swallow Screen inclusion criteria launched at the end of Q4 of 2024.The ED manager and Stroke Coordinator worked together throughout Q4, 2024 to identify nurses that needed an increased level of education to ensure there was clear understanding amongst the entire ED nurse group for compliance and buy in. Results: SAFH saw marked improvement of Swallow Screen Compliance, with 100% AHASTR306 Rural Stroke Dysphagia Screen compliance from January-June, 2025.Additionally, an increased performance of swallow screen completion for all patients with stroke, stroke-like symptoms and transient ischemic attack (TIA) to over 95%.Of the five patients that had a fall out in sallow screen prior to oral intake one was a TIA and two presented with mixed symptoms indicative of potential SEPSIS or infection, but MRI was positive for acute infarct days later.“Swallow Screen for head CT” increase compliance for those patients that were initially ruled to not have an infarct via CT scan but were diagnosed during hospitalization via MRI. Conclusion: Simple steps have helped embed the swallow screen process in nursing practice, achieving 100% compliance for TNK patients and improving safety for non-interventional stroke patients.Continued efforts are needed to include patients with mixed or unclear symptoms in the screening.