Preventing Aspiration Among Older Adults in Long-term Care.

BACKGROUND

More than 60% of older adults living in long-term care facilities are at higher risk for pneumonia, aspiration, and malnutrition due to oropharyngeal dysphagia. Survey findings at a long-term care facility serving veterans revealed variation in dysphagia-related care performance and knowledge gaps. This quality improvement project aimed to reduce aspiration and pneumonia rates by 25% and the daily incidence rate of abnormal vital signs, indicating microaspiration events.

METHODS

Plan-Do-Study-Act was utilized in a long-term care facility serving veterans. Rates of aspiration, pneumonia, and abnormal vital signs were analyzed to evaluate outcomes, Independent t test was used to analyze pre-education-post-education knowledge tests.

INTERVENTIONS: Education on dysphagia management, signage communicating dysphagia-related orders, and weekly mealtime observations were implemented to improve knowledge, application, and consistency of correct practice.

RESULTS

Long-term care facility residents (n = 59; mean age, 77 years; 93.1% male) saw reduced rates of aspiration and pneumonia (47.4%, P = .022) and abnormal vital signs (51.8%, P < .001), Unintended weight loss was prevented by 37.2% (P = .034). Pre-post tests indicated a 52.6% improvement in knowledge among nursing staff, t53 = 7.604, P < .001.

CONCLUSION

Expanding education and improving accessibility to care-related orders to all nursing staff improved safety among long-term care residents.