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Expert Nursing Knowledge in the Care of Patients at Risk of Impaired Swallowing
Author(s) -
McHale Jeanne M.,
Phipps Marion A.,
Horvath Kathy,
Schmelz Joseph
Publication year - 1998
Publication title -
image: the journal of nursing scholarship
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.009
H-Index - 80
eISSN - 1547-5069
pISSN - 0743-5150
DOI - 10.1111/j.1547-5069.1998.tb01268.x
Subject(s) - swallowing , nonprobability sampling , nursing , narrative , nursing care , medicine , exploratory research , psychology , medical education , dentistry , population , linguistics , philosophy , environmental health , sociology , anthropology
Purpose: To describe the practical knowledge of expert nurses when they assess and feed patients at risk of impaired swallowing. Observation uncovered a lack of well‐developed nursing practices in assessing patients' swallowing and eating, and a wide range of inter ventions in the care of difficult‐to‐feed‐patients. Finding little previous nursing research to guide practice for patients with impaired swallowing, the authors undertook a study to identify and describe the knowledge embedded in the everyday practice of nurses. Design: Descriptive, exploratory using purposive sampling. Twelve nurses were identified in 1994 as expert in the care of patients at risk of impaired swallowing in one Boston, Massachusetts teaching hospital. Methods: Data were collected using written narratives by each participant; group interviews in which nurses discussed the written narratives; nonparticipant observations and individual interviews of the expert nurses; and patients' chart review. Data were analyzed using interpretive phenomenology. Findings: Most nurses in the study did not perform a complete assessment of swallowing before feeding their patients. Yet, through feeding patients, they were able to describe several components of the swaliowing assessment used in their practice. Conclusions: The areas of assessment described by the nurses can serve as a template for the development of educational content and assessment tools for swallowing.