title: Evaluating a novel approach to enhancing dysphagia management: workplace-based, blended e-learning.
abstract: OBJECTIVE
  To evaluate the learning effect and resource use cost of workplace-based, blended e-learning about dysphagia for stroke rehabilitation nurses.
  
  
  BACKGROUND
  Dysphagia is a potentially life-threatening problem that compromises quality of life. In many countries, nurses play a crucial role in supporting the management of patients with swallowing problems, yet the literature reports a need for training.
  
  
  METHODS
  A single-group, pre- and post-study with mixed methods.
  
  
  METHODS
  Each blended e-learning session comprised a needs analysis, e-learning programmes, practical skills about modifying fluids and action planning to transfer learning into practice. Participants were the population of registered nurses (n = 22) and healthcare assistants (n = 10) on a stroke rehabilitation ward in a large, teaching hospital in England between August 2010-March 2011. Data collection comprised observation (34 hours), questionnaires administered at four time points to examine change in attitude, knowledge and practice, and estimating the resource use cost for the service. Nonparametric tests and content analysis were used to analyse the data.
  
  
  RESULTS
  All participants achieved a nationally recognised level of competence. The learning effect was evident on the post- and follow-up measures, with some items of dysphagia knowledge and attitude achieving significance at the p ≤ 0·05 level. The most common self-reported changes in practice related to medicines management, thickening fluids and oral hygiene. The resource use cost was estimated at £2688 for 108 hours training.
  
  
  CONCLUSIONS
  Workplace-based, blended e-learning was an acceptable, cost effective way of delivering essential clinical knowledge and skills about dysphagia.
  
  
  CONCLUSIONS
  Dysphagia should be viewed as a patient safety issue because of the risks of malnutrition, dehydration and aspiration pneumonia. As such, it is pertinent to many members of the interdisciplinary team. Consideration should be given to including dysphagia management in initial education and continuing professional development programmes.
authors: NIHR CLAHRCSY, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
authors: Irene
authors: I
authors: Ilott
authors: Bev
authors: B
authors: Bennett
authors: Kate
authors: K
authors: Gerrish
authors: Sue
authors: S
authors: Pownall
authors: Amanda
authors: A
authors: Jones
authors: Andrew
authors: A
authors: Garth
mesh_terms: D000368:Aged; D003365:Costs and Cost Analysis; D003680:Deglutition Disorders / Q000451:nursing* / Q000534:rehabilitation; D004509:Education, Nursing, Continuing / Q000191:economics*; D004739:England; D006801:Humans; D020407:Internet; D008875:Middle Aged; D009736:Nursing Process / Q000191:economics*; D011795:Surveys and Questionnaires; D017132:Workplace
keywords: dysphagia; mixed method; nurses; patient safety; resource use costs; stroke; workplace-based blended e-learning