Effect of Competency-Based Program on Nurses' Performance and Outcomes of Patients with Post-Stroke Dysphagia

Abstract

Background: Nurses play a crucial role in managing patients who have difficulty swallowing. Managers and nursing researchers should create and provide effective training for nurses to improve their knowledge, attitude, and practice regarding poststroke dysphagia, thereby improving patient outcomes. The aim of this study was to evaluate the effect of competency-based program on nurses' performance and outcomes of patients with post-stroke dysphagia. Design: A quasi-experimental design was used to achieve the aim of the study using a pre-/post-test approach. Setting: This study sample was recruited from the neurological inpatient department and stroke care unit at Ain Shams University Hospital. Subjects: A convenient sample included all available nurses (40) working in neurological inpatient units and stroke care units which were affiliated to the Ain Shams University Hospital. A purposive sample of 60 patients from both genders with diagnosis of recent stroke from the previously mentioned setting. Study Tools: Data was collected through four tools. (1) Nurses self-administered structured questionnaire; (2) nurses ‘observational checklist (3) Nurses' attitudes scale; and (4) Patients' outcomes assessment tool. Results: This result revealed that nurses' knowledge, practice, and attitude regarding poststroke dysphagia were statistically significantly improved at post- and follow up implementation phases as compared to pre-implementation phase (X2=24.34 & 20.26 at p <0.001; X2=19.00 &17.00 at p<0.001; and X2=13.067&15.017at p<0.001 respectively). Also, there was statistically significant variation between study and control group patients regarding dysphagia severity (0.0072) and total swallowing quality of life composite score (p=0.01). Conclusion: There was significant improvement in nurses' performance and outcomes of patients with poststroke dysphagia after implementation of nursing competency-based program. Recommendation: Continuous in-service competency-based programs for nurses caring for patients with stroke to refresh and update their knowledge and practice on post-stroke dysphagia assessment and management.