A consensus based approach to the development of a digital dysphagia management guide for care homes (abstract only)

Background Dysphagia (difficulty swallowing) is common in older people. Up to 75% of residents in nursing homes have swallowing difficulties. Effective management of dysphagia is complex and multi-dimensional. Without proper understanding of what is needed residents’ health and well-being are compromised. An integrated whole systems approach across both catering and clinical services is required. Aim To develop and evaluate an evidence based digital guide to effectively manage dysphagia in care homes. Study Design A consensus based, co-design approach was used to:  Examine the evidence-base, views of residents, staff and company representatives to better understand management and shared decision-making in dysphagia care.  Co-design a digital guide that promotes adoption of best practice.  Conduct a validation process of the guide. Findings A purposive sample of four homes were recruited. Eight focus groups were conducted with 37 members of the workforce and individual semi-structured interviews were carried out with 4 care home managers, 4 quality managers and 6 residents. Analysis determined four key themes around good practice: Training, Food, Quality and Safety, and Workforce. Themes were used to design a digital guide incorporating text, photographs and videos, to enable staff to use the evidence to support their residents to eat and drink safely. The Guide was piloted by 57 staff over 12 weeks. Remote monitoring of activity showed that pages were displayed a total of 1913 times, with Food as the most viewed section (33%). 73% of people reported the Guide helped them do their job more effectively and 88% would recommend the Guide to others. 90% reported the Guide was easy to use. Discussion Using a co-design approach to the development of a digital guide to support dysphagia management in care homes resulted in a resource which was evaluated positively for content, design and usability. Funding is now being sought for a large scale evaluation.