Background Evidence suggests 30–40% of patients with a neck of femur fracture (NOF#) develop oropharyngeal dysphagia (OPD) during the perioperative period. 1–2 Our data, collected over two months, shows our Speech and Language Therapy Team (SLT) identified only 12% of cases. Given the importance of nutrition and medication in the perioperative period, early identification of OPD is critical. We launched a new dysphagia screening tool for all patients admitted to our hospital with a NOF#. Methods A retrospective review of patient notes allowed collection of data regarding age, hip injury, frailty score, comorbidities, and staff compliance with tool. Patients with a completed screening tool had outcomes recorded (low, medium, high risk), timeliness of referral to SLT if appropriate, and if OPD was present on assessment. Balancing measures included length of time kept nil by mouth. We completed four PDSA cycles over 5 months. Results During this period, 157 patients were admitted with a NOF# and 58 had a completed screening tool. By producing a training pack and expanding into the emergency department, compliance improved by 33% over the 4 cycles. 19 of the 58 patients with a completed screening tool had OPD; 79% had mild, 14% moderate and 7% severe. The screen was adjusted during each cycle improving the suitability of SLT referrals from a 25% identification rate in cycle 1 to 100% in cycle 4. No patients were kept nil by mouth. Conclusions The screening tool has increased OPD identification by 21%. However, this requires staff training and high compliance rates to be effective. Next steps include adding the tool to the NOF# proforma, creating a training pack for the wider MDT, and improving the specificity of the tool. References 1. Love et al. Age and Ageing, 2013. 42(6):782–5. 2. Mateos-Nozal J et al. Age and Ageing, 2021. 28;50(4):1416–1421.

中文翻译：

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2308 为股骨骨折患者实施吞咽困难筛查工具的试点项目。


背景证据表明，30-40% 的股骨颈骨折 （NOF#） 患者在围手术期出现口咽吞咽困难 （OPD）。1-2 我们收集了两个多月的数据，显示我们的言语和语言治疗团队 （SLT） 仅发现了 12% 的病例。鉴于围手术期营养和药物治疗的重要性，早期识别 OPD 至关重要。我们为我们医院收治的所有 NOF# 患者推出了一种新的吞咽困难筛查工具。方法 对患者笔记进行回顾性回顾，可以收集有关年龄、髋关节损伤、虚弱评分、合并症和工作人员对工具的依从性的数据。完成筛查工具的患者记录了结局 （低、中、高风险）、转诊至 SLT 的及时性（如果合适），以及评估时是否存在 OPD。平衡措施包括口服 ni 的时间长度。我们在 5 个月内完成了四个 PDSA 周期。结果 在此期间，157 例患者以 NOF# 入院，58 例患者完成了筛查工具。通过制作培训包并扩展到急诊科，依从性在 4 个周期中提高了 33%。完成筛查工具的 58 例患者中有 19 例患有 OPD;79% 为轻度，14% 为中度，7% 为重度。在每个周期中调整筛选，提高 SLT 转诊的适用性，从第 1 周期的 25% 识别率提高到第 4 周期的 100%。没有患者经口保持零。结论 筛查工具使 OPD 识别率提高了 21%。然而，这需要员工培训和高合规率才能有效。后续步骤包括将该工具添加到 NOF# 形式中，为更广泛的 MDT 创建培训包，并提高工具的特异性。参考资料 1.Love 等人。年龄与老龄化，2013 年。 42(6):782–5.2. Mateos-Nozal J 等人。年龄与老龄化，2021 年。28;50(4):1416–1421.