Dysphagia e-learning programmes

Three e-learning programmes were trialled during the project.  
They were :

STARS 1:  
Stroke Core Competencies for Health and Social Care Staff.  No. 13 Swallowing.  
See here  

STARS 2:  
Stroke Advancing Modules.  No. 3 Feeding, hydration and nutrition following a stroke.  
See here

Skills for Health Core Learning Unit: 
The Dysphagia Tutorial was developed by the National Patient Safety Agency (NPSA).   
An NHS email address is required to register and access the tutorial.  
See here

Inter-Professional Dysphagia Competence Framework

The Inter-Professional Dysphagia Competence Framework (Boaden et al 2006) aims to inform strategies for developing the skills, knowledge and ability of speech and language therapists, nurses and other healthcare professionals/non-registered staff, to contribute more effectively in the identification of people with, and in the management of, feeding/swallowing difficulties.

It is a nationally recognised framework, developed with funding from the National Patient Safety Agency (NPSA); the NHS Modernisation Agency Changing Workforce Programme; North and East Yorkshire, North Lincolnshire and South Yorkshire Workforce Development Confederations; and the National Stroke Nursing Forum. The Framework is recognised by a number of professional associations including the Royal College of Physicians; the Royal College of Nurses; the Royal College of Speech and Language Therapists; the British Dietetics Association; and also by Skills for Health.   

The Framework refers to five levels of dysphagia practitioner. These are:

  • Awareness
  • Assistant Dysphagia Practitioner
  • Foundation Dysphagia Practitioner
  • Specialist Dysphagia Practitioner
  • Consultant Dysphagia Practitioner

For more information about the Framework, see here

In 2006, the Assistant Dysphagia Practitioner competences were mapped against the equivalent of National Occupational Standards.   In July 2010, Skills for Health updated the three National Occupational Standards for Assistant Dysphagia Practitioner competence.   The three Clinical Health Skills are available on the Skills for Health website.  These are:  

  • CHS159 (formerly AHP26) Provide support to individuals to develop their skills in managing dysphagia 

  • CHS 160 (formerly AHP27) Assist others to monitor individuals’ attempts at managing dysphagia

  • HSC214 Help individuals to eat and drink

See Skills for Health Competences/National Occupational Standards here

General resources about dysphagia

Dysphagiais a multidisciplinary journal devoted to swallowing and its disorders - See here 

NHS Choices is an on-line encyclopaedia with information about the symptoms, causes, diagnosis, treatment and complications of dysphagia - See here

National Patient Safety Agency (NPSA) produced guidance about ‘Ensuring safer practice for adults with learning disabilities who have dysphagia’ in 2007.  There are also leaflets, risk management tools and reports on the website - See here

DVD: ‘Oh good, lunch is coming.’  A 20 minute DVD produced by the Dementia Services Development Centre, University of Stirling (2002). Cost £20.00 - See here

The Stroke Association publishes a 4-page fact sheet about ‘Swallowing problems after stroke’ (Number 5, published December 2010) - See here

Health Talk On-line has accounts of how people with a stroke cope with problems eating and drinking - See here

Further reading about dysphagia, nutrition and stroke 

Ashford J, McCabe D, Wheeler-Hagland D, et al (2009) 
Evidence-based systematic review: Oropharyngeal dysphagia behavioral treatments. 
Part III—Impact of dysphagia treatments on populations with neurological disorders. 

Journal of Rehabilitation and Research, 46, 2, 195-204.

Bath PMW, Bath-Hextall FJ, Smithard D (1999)
Interventions for dysphagia in acute stroke. 
Cochrane Database of Systematic Reviews 1999, Issue 4. Art. No.: CD000323. 
DOI: 10.1002/14651858.CD000323.  

Available here

Boaden EE et al (2006)  
Inter-professional Dysphagia Framework on behalf of the National Dysphagia Competence Steering Group.  
University of Central Lancashire, Preston. 

British Dietetic Association & Royal College of Speech and Language Therapists (2002) 
National Descriptors for Texture Modification in Adults.  

Care Quality Commission/Royal College of Nursing (October 2010) 
Essential standards of quality and safety. 
Care Quality Commission, London. 

Campbell D (2005) 
SIGN stroke guideline addresses needs of patients with dysphagia. 
Guidelines in Practice, 8, 1, 21-28.

Colodny N (2001) 
Construction and validation of the mealtime and dysphagia questionnaire: an instrument designed to assess nursing staff reasons for noncompliance with SLP dysphagia and feeding recommendations.  Dysphagia, 16, 263-271.

Colodny N (2005) 
Dysphagia independent feeders justification for noncompliance with recommendations by a speech language pathologist. 
Am Journal of Speech-Language Pathology, 14, 61-70.

Mann G et al (1999) 
Swallowing function after stroke. Prognosis and prognostic factors at six months.  
Stroke, 744-748.

McArthur KS et al (2011) Clinical review.  
Post-acute care and secondary prevention after ischaemic stroke.  
British Medical Journal, 342:2083 doi 10.1136/bmj.d2083

Medin J et al (2011) 
Eating difficulties among patients 3 months after stroke in relation to the acute phase.  
Journal of Advanced Nursing, doi:10.1111/j.1365-2648.2011.05759.x

National Collaborating Centre for Chronic Conditions (2008) 
Stroke: national clinical guideline for diagnosis and initial management of acute stroke and transient ischaemic attack (TIA). 
London: Royal College of Physicians. 

Available here

National Patient Safety Agency, Royal College of Speech and Language Therapists, The British Dietetic Association, the National Nurses Nutrition Group and the Hospital Caterers Association
(April 2011) Dysphagia diet food texture descriptors.  

Available here

O'Loughlin, G. & Shanley, C. (1998) 
Swallowing problems in the nursing home: a novel training response. 
Dysphagia, 13, 172-183.

Pownall S (2009) 
Investigations into the management of patients presenting with dysphagia following stroke.  
School of Health and Health Related Research, University of Sheffield, Sheffield. 

Royal College of Physicians and British Society of Gastroenterology (2010) 
Oral feeding difficulties and dilemmas: A guide to practical care, particularly towards the end of life. 
London: Royal College of Physicians.  

Available here

References about e-learning

Booth A et al (2009) 
Applying findings from a systematic review of workplace-based e-learning: implications for health information professionals. 
Health Information and Libraries Journal, 
26, 4–21.

Carroll C et al (2009) 
UK Health-care professionals’ experience of on-line learning techniques: a systematic review of qualitative data. 
Journal of Continuing Education in the Health Professions, 29, 4, 235-241.

Department for Education and Skills (DfES) (2003) 
Towards a unified e-learning strategy. 
London: DfES.  
Available here

Department of Health (2011) 
A framework for technology enhanced learning. 
Available here

Moule P et al (2011) 
Issues with e-learning in nursing and health education in the UK: are new technologies being embraced in the teaching and learning environments.  
Journal of Research in Nursing, 16, 1, 77-90.

National Workforce Group (2005) 
Supporting Best Practice in e-Learning across the NHS
Available here

Project Specific References

Boaden R et al (2009) 
Guidance on ethical considerations for CLAHRC implementation activity

NIHR CLAHRC Directors Group. 
Available here

Curtis L (2010) 
Unit Costs of Health and Social Care

Personal Social Services Research Unit, Canterbury: University of Kent.  
Available here