{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T02:01:45Z","timestamp":1784512905396,"version":"3.55.0"},"reference-count":29,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,7,19]],"date-time":"2026-07-19T00:00:00Z","timestamp":1784419200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,7,19]],"date-time":"2026-07-19T00:00:00Z","timestamp":1784419200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Clinical Nursing"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims and Objectives<\/jats:title>\n                    <jats:p>To examine how registered nurses (RNs) and licensed practical nurses (LPNs) working in skilled nursing and long\u2010term care settings experience dysphagia and cognitive\u2010communication disorder (CCD) care, with attention to barriers, facilitators and frontline adaptive strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Nurses play a central role in implementing care for individuals with dysphagia and CCD; however, care delivery is often shaped by inconsistent training, limited interprofessional coordination and variable institutional support, contributing to gaps between evidence\u2010based recommendations and practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Qualitative descriptive study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Semi\u2010structured interviews were conducted with 19 nurses (9 RNs, 10 LPNs). Interviews were audio\u2010recorded, transcribed verbatim and analysed using inductive thematic analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Three interrelated themes were identified describing: (1) the visibility gap between dysphagia and cognitive\u2010communication disorders (CCD) in everyday nursing practice, (2) systemic and interprofessional barriers shaping care implementation and (3) the emotional and ethical burdens associated with frontline nursing care. Dysphagia was consistently prioritised as an immediate safety concern, whereas CCD remained less visible and was often managed through informal practices.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Nurses play a central role in translating clinical recommendations into everyday care practice. Dysphagia was consistently prioritised as an immediate patient safety concern, whereas CCD appeared less visible and less systematically managed within routine nursing care. Variability in training, communication and institutional support contributes to inconsistencies in care delivery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jocn.70456","type":"journal-article","created":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T01:09:52Z","timestamp":1784509792000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Implementing Dysphagia and Cognitive\u2010Communication Disorder Care: Frontline Perspectives From Nurses in Skilled Nursing and Long\u2010Term Care"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0677-9591","authenticated-orcid":false,"given":"Sundeep","family":"Venkatesan","sequence":"first","affiliation":[{"name":"Division of Speech\u2010Language Pathology, Decker College of Nursing and Health Sciences Binghamton University, State University of New York  Binghamton New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7401-3707","authenticated-orcid":false,"given":"Rodney","family":"Gabel","sequence":"additional","affiliation":[{"name":"Division of Speech\u2010Language Pathology, Decker College of Nursing and Health Sciences Binghamton University, State University of New York  Binghamton New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-5887-4996","authenticated-orcid":false,"given":"Stacey L.","family":"Pavelko","sequence":"additional","affiliation":[{"name":"Communication Sciences &amp; Disorders, Nicole Wertheim College of Nursing &amp; Health Sciences Florida International University  Miami Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6298-3960","authenticated-orcid":false,"given":"Ann E.","family":"Fronczek","sequence":"additional","affiliation":[{"name":"Decker College of Nursing and Health Sciences, Binghamton University, State University of New York  Binghamton New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,19]]},"reference":[{"issue":"6","key":"e_1_2_14_2_1","first-page":"29","article-title":"The Level of Jordanian Nurse's Knowledge About Dysphagia: Descriptive Study","volume":"6","author":"Abu\u2010Snieneh H.","year":"2017","journal-title":"International Journal of Applied and Natural Sciences"},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.1044\/2025_PERSP\u201024\u201000251"},{"key":"e_1_2_14_4_1","doi-asserted-by":"publisher","DOI":"10.1108\/jhom\u201012\u20102018\u20100363"},{"key":"e_1_2_14_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/scs.12753"},{"key":"e_1_2_14_6_1","doi-asserted-by":"publisher","DOI":"10.1191\/1478088706qp063oa"},{"key":"e_1_2_14_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.NURSE.0000547723.69610.20"},{"issue":"5","key":"e_1_2_14_8_1","first-page":"1","article-title":"Can Using a Communication Tool Within the Emergency Department Enhance Verbal Interactions Between Nurses and Patients With Moderate Cognitive Impairment Related to Dementia","volume":"1","author":"Cleeve G.","year":"2013","journal-title":"Health Sciences"},{"key":"e_1_2_14_9_1","volume-title":"Qualitative Inquiry and Research Design: Choosing Among Five Approaches","author":"Creswell J. 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